@article{1143,
  keywords = {Patient experience, Systems issues, Content analysis, Mixed methods},
  author = {Alana Conner and Beatrice Podtschaske and Mary Mazza and Dani Zionts and Elizabeth Malcolm and Carey Thomson and Sara Singer and Arnold Milstein},
  title = {Care Teams Misunderstand What Most Upsets Patients About Their Care},
  abstract = {<p>Background: Negative healthcare delivery experiences can cause lasting patient distress and medical service misuse and disuse. Yet no multi-site study has examined whether care-team members understand what most upsets patients about their care.<br />
Methods: We interviewed 373 patients and 360 care-team members in the medical oncology and ambulatory surgery clinics of 11 major healthcare organizations across six U.S. census regions. Patients deeply upset by a service-related experience (n = 99, 27%) answered questions about that experience, while care-team members (n = 360) answered questions about their beliefs regarding what most upsets patients. We performed content analysis to identify memorably upsetting care (MUC) themes; a generalized estimating equation to explore whether MUC theme mention frequencies varied by participant role (care-team member vs. patient), specialty (oncology vs. surgery), facility (academic vs. community), and gender; and logistic regressions to investigate the effects of participant characteristics on individual themes.<br />
Results: MUC themes included three systems issues (inefficiencies, access barriers, and facilities problems) and four care-team issues (miscommunication, neglect, coldness, and incompetence). MUC theme frequencies differed by role (all Ps &lt; 0.001), with more patients mentioning care-team coldness (OR = 0.37; 95% CI, 0.23-0.60) and incompetence (OR = 0.17; 95% CI, 0.09-0.31); but more care-team members mentioning system inefficiencies (OR = 7.01; 95% CI, 4.31-11.40) and access barriers (OR, 5.48; 95% CI, 2.81-10.69).<br />
Conclusions: When considering which service experiences most upset patients, care-team members underestimate the impact of their own behaviors and overestimate the impact of systems issues.<br />
Implications: Healthcare systems should reconsider how they collect, interpret, disseminate, and respond to patient service reports.</p>
},
  year = {2022},
  booktitle = {Healthcare},
  journal = {Healthcare},
  volume = {10},
  number = {4},
  pages = {100657},
  month = {12/2022},
  publisher = {Elsevier},
  address = {Amsterdam},
  issn = {2213-0764},
  url = {https://www.sciencedirect.com/science/article/pii/S221307642200046X},
  doi = {https://doi.org/10.1016/j.hjdsi.2022.100657},
}