Patient Centred Care
Patient and Care Partner Preferences and Prioritized Outcomes
Patient and caregiver preferences and prioritized outcomes for cardiac surgery: A scoping review and consultation workshop
Study aims: to identify patient and caregiver preferences and prioritized outcomes related to peri-operative care in cardiac surgery and its lifelong impact.
What we did: We conducted a scoping review of five electronic databases. We included 43 studies that investigated patient or caregiver preferences and prioritized outcomes. Findings were summarized using descriptive statistics and a thematic analysis. Ten patients and seven caregivers were involved in a consultation workshop to validate or add to the findings.
What we found: Based on the collective preferences of 3772 patients and caregivers from the review and 17 from the consultation workshop, a total of 108 patient preferences, 32 caregiver preferences, and 19 prioritized outcomes were identified. Patient and caregiver preferences overlap with the current recommended strategies to reduce risk and improve recovery among cardiac surgery patients.
Barriers to Successful Discharge After Cardiac Surgery: A Focus Group Study and Cross-Sectional Survey
Study aims: To investigate patient, caregiver, and health care provider perceptions of the discharge process after cardiac surgery.
What we did: Sixteen patients and sixteen caregivers participated in four focus groups. The focus group discussions were used to develop surveys about values, barriers, and challenges relating to the discharge process. Seventy-eight patients, 34 caregivers, 53 nurses and/or other allied health professionals, and 8 surgeons completed the surveys.
What we found: Four themes emerged from the focus groups (1) a lack of understanding about the discharge process and when it is appropriate, (2) issues relating to information provided to patients at discharge, (3) experiences with the health care system, and (4) the experiences of caregivers. According to the survey responses, the most important part of the discharge process for patients and caregivers was "knowing what to do in an emergency.” Patients and caregivers differed most from healthcare providers regarding their thoughts on informational barriers to discharge. Overall, patient and caregiver values should inform the post-cardiac surgery discharge to promote successful recovery.
Expanding enhanced recovery protocols for
cardiac surgery to include the patient
voice: A scoping review protocol
Study aim: To describe a protocol for a scoping review of cardiac patient and caregiver preferences and outcomes relevant to cardiac surgery enhanced recovery protocols.
What we did: We describe a protocol for a scoping review of existing literature describing patient and caregiver preferences and outcomes as they relate to care received in the peri-operative period of cardiac surgery. The search for relevant articles will be conducted using electronic databases and other online sources. Two patient partners with lived experience as cardiac surgery patients will be involved as collaborators.
Expected contributions: This review will identify strategies that can be integrated into enhanced recovery protocols for cardiac surgery which align with patient- and caregiver-defined values.
Mobile Health
Use of a mobile health application by adult
non-congenital cardiac surgery patients:
A feasibility study
Study aims: To evaluate the feasibility (compliance, usability and user satisfaction) of a mobile health app for delivering Enhanced Recovery Protocols to cardiac surgery patients peri-operatively.
What we did: Sixty-five cardiac surgery patients were given access to the app and completed system usability, satisfaction, and quality of life surveys before and after their cardiac surgery.
What we found: Mobile health technology is feasible for peri-operative cardiac surgery patient education, including older adult patients. The majority of patients were satisfied with the app and would recommend using it over the use of printed materials.
Patient Engagement in the Design of a Mobile Health App That
Supports Enhanced Recovery Protocols for Cardiac Surgery:
Development Study
Study aims: to describe a process for, and the impact of, patient engagement in the development of a mobile Health app that supports patient and caregiver involvement with enhanced recovery protocols during the peri-operative period of cardiac surgery.
What we did: Ten cardiac surgery patients and their caregivers formed an advisory panel. Themes were generated from discussions with the advisory panel to describe (1) the key messages they provided (2) how key messages were incorporated into the app, and (3) feedback from the app developers.
What we found: The advisory panel generated seven key messages about app design and 16 key messages about app content. This information was directly incorporated into the app. The advisory panel provided unique recommendations that the app developers had not previously considered. Patient engagement may facilitate the development of a detail-oriented and patient-centered mobile health app whose design and content are driven by the lived experiences of end users.