Transcript 1 – Coded
I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.
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First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent? I guess excellent care was when people listened and did something after hearing me. Can you describe something that actually happened. Yes the nurse came in and asked how Iwas doing. I told her as well as can be expected. Except she didn’t stop there. She asked me what I meant by as “well as can be expected”… “Like what was happening now”. I told her about the pain I was having and that I was sure it would get better. |
courteous probing, clarifying showing emotions, verbalizing condition probing assessment intervening, advocating positive outcome |
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Are there other examples of what you thought was excellent care? Not that I can think of although things were really pretty good. I guess what stands out is that people reallylistened. They would come in and they would ask if they could do anything and they would remind me that they had time. I guess that made me think that it would be all right to ask things. Like one time I asked if they would walk me as I was having stiffness in my legs. Another time I requested that they explain something to my wife about my newmedicines. I’m not sure I would’ve asked if they hadn’t said they had time. Another good thing was how they told me about my medicines. |
appreciative attentive, grateful patience comfortable, reassured patient education |
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Can you tell me more about that? What kind of instructions were you receiving? I was told I was going home on Coumadin. The nurse who brought me the Coumadin started to explain what it was and why I was getting it. I had hip surgery and they were worried about a possible blood clot. The doctor had said I would go home on it. |
patient education, discharge instructions |
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Can you provide any examples of when you were not satisfied or not happy with the care you were receiving Well probably most upsetting was the noise at night. I had a roommate who cried and cried. I think he was senile. And he made so much noise that I could not sleep. I guess it was no one’s fault but it sure made the whole experience difficult. The other hard thing was knowing that I had treatments but not knowing when Iwould be getting them. I needed to go to physical therapy twice a day. I would get myself ready in the morning and then I would wait and I would wait and I would wait and sometimes they never came until close to noon and I’m supposed to have a twice a day and because I would just be getting back at 1:30 they never made it back to get me for the second time. I want to make sure my rehab goes well. I should’ve been getting my physical therapy. And I guess overall it is hard being inthe hospital.There is really nothing people can do to make it better I guess. But why do so many people come in to do things to you and never introducethemselves or even ask your permission- it’s like another world. Come in do what they want. Speak about you to others asif you aren’t even there and walk out the door. |
sharing lack of communication, expressing concerns lack of communication expressing concerns defeated lack of privacy, discourteous invisible |
Transcript 2 – Coded
I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.
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First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent? I can tell you what excellent care is but it sure didn’t happen here. Excellent care would be when there was care. It was like I never saw a nurse. They would come in give me medications and then be gone. I put my call light on and this voice would come over the intercom and say “someone will be right in” and of course no one came right in. It was very frustrating. I couldn’t ambulate on my own. I needed assistance to even feed myself. They would bring in my trays for meals and it would sit on my table. Having had a stroke I couldn’t feed myself. I couldn’t take the lids off. My meal would sit there and get colder and colder and colder. Then the nursing assistant would come in and say I’m here to feed you and would try feeding me cold food. I probably wouldn’t of liked it hot either I sound like a crabby old lady don’t I? But it was a very scary time. My room was at the end of the hall. I felt alone and I was scared.And when people did come in they really were more interested in my tubes in my weakness. |
dissatisfaction abandoned, frustrated abandoned frustrated, irritated helpless, aggravated dependent uncaring, unconcerned alone, scared no empathy, inconsiderate lack of introduction helpless, trapped |
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Can you provide any examples of when you were not satisfied or not happy with the care you were receiving? I guess it was hard when it seemed like no one communicated with each other. One nurse did not know what another nurse had done. It doesn’t make you feel comfortable when you think they don’t know what is going on. The doctors are even worse…they clearly never talk with other nurses and doctors. How are you supposed to feel secure when you don’t think those who are supposed to take care of you know what they need to know about you or the care. |
lack of communication lack of collaboration uncomfortable lack of trust, lack of collaboration insecurity, expressing concerns |
Transcript 3– Coded
I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.
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First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent? Excellent care was when people were kind. I had gotten some bad news about uterine cancer. The nurse, her name is Josie, she sat next to me, took my hand, and asked how I was doing. I felt likeshe really cared. It also helped. To share my fear with someone who could give me information. Information… that really helped. This was my first time being sick and finding out that you needed surgery and chemotherapy was very difficult. I was angry at first as the doctor came in and told me the diagnosis and told me that I would be scheduled for surgery the next day and then I would need chemotherapy afterwards. He didn’t even give me a choice. It was Josie who told me that I could ask the doctor aboutoptions. That I did have a right to make my own choice. I didn’t know how to askthe doctor. So she made him come back to see me. She told him that I wanted to know what my options were. He really was very nice. We all sat and talked for a very long time about what the differentapproaches could be with the pros and cons. I did choose to go ahead with surgery. But I felt better about it after having been given the information. Don’t treat me as if I can’t think for myself. It’s my body. Josie understood that. |
appreciative, thankful attentive, personal touch, approachable caring patient education angry, expressing emotions lack of options, lack of control empowered, informed doubtful, intimidated patient advocate patient education felt relieved, knowledgeable, informed taking back control expressing emotions dissatisfied anxiety, expressing emotions |
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What other things did Josie do that made you feel like you were getting excellent care? Gee I don’t know. She treated me as anindividual. She asked me what I wanted. She told me I got to make decisions. And she gave me information. I wasoverwhelmed. She would give me information in small doses. Then she would come back. I never felt I was abother. And I guess another thing was how she talked to my husband. She told him that she knew it was a difficult time for me but that it was likely hardfor him as well. And that she was there to answer his questions. And not to feel uncomfortable asking. I think that make him feel more relaxed. He always looked for her. |
compassionate patient advocate discussing options overwhelmed patient education comfortable, reassured empathetic comfortable |
Transcript 4– Coded
I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.
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First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent? What was excellent? I think everyone paid a lot of attention to my wound and how it was healing. They measured it every day. They examined it. They asked me about it. They would share theirthoughts about how it was doing. That helped. I wanted to know about how I was progressing. I wanted information and they shared information about the wound, the treatment and all. Yes, I think Iwould say it was excellent- they knew not just what was happening at the time but how it was from the previous few days. |
attentive assessment information, patient education open communication, informed positive feedback, expressing emotions good staff communication |
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Can you provide any examples of when you were not satisfied or not happy with the care you were receiving? I was there for the wound so I shouldn’t complain as the wound care was good. But it’s not easy being a patient in the hospital. No, it’s not easy. One thing that bothered me is that they called me “Pops”. I guess because I am older. I wanted to say- I’m not your Pops. It was people trying to be nice but Pops? Really? And some people didn’t call me by name or call me Pops they just came in and did what they had to do. Like Iwasn’t even there. And of course they would automatically talk loud- I thinkthey looked at me and said well he’s an old man so I will just shout so he can hear me. There was one day when I was not doing well and the nurse told my daughter that I was a little out of it- she asked what he meant and he told her- you know confused but that comes with being in your 80s. She was not pleased with him- explained to him that I was not normally confused that something must be happening- later that day they found that I was septic and they started antibiotics by IV. No one stops to find out who you are. |
satisfied expressing emotions unprofessionalism invisible, ignored stereotyping, false assumption stereotyping, false assumption poor assessment (confused vs septic) impersonal |
Transcript 5– Coded
I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.
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First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent? The nurses in ICU were excellent. Theywere so professional. They knew what was happening with me- were constantly checking me and reassuring me andtelling me what was happening. I had a mild stroke and I was of course scared. And the ICU was scary but the nurses explained what the machines were. What the sounds were coming from the machines and what the machines were monitoring. I got to the point that I felt safe with the machines- it was a little scary to have them take off the machines but the nurses were so attentive – and they told me about how coming off the machine was a sign of my progress. I felt good about that- made me feel hopeful. I felt very comfortable asking questions to them and I have not always felt that way when I have been in the hospital before.When I was in the hospital the last time (somewhere else) I felt that no one listened to me. The other thing they did was that when my husband and children would visit, the nurses would update them on how I wasdoing.They would ask them if they saw anything that they were concerned about or if they had questions. I think my kids are more scared then I am so that was really excellent. And they were so accommodating- they let my children visit whenever they wanted. Bobby works long hours so he might not get to the hospital until after 10 at night- theylet him come in – he would just sit there if I was sleeping. The nurses filled him in on how I was doing. It was so reassuring to me to have my family present. |
appreciative, pleased professionalism awareness, positive feedback unit orientation, patient education patient education reassuring past experiences family involvement inclusive, informative accommodating, supportive, flexible accommodating reassuring |
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Can you provide any examples of when you were not satisfied or not happy with the care you were receiving? Well, when I left ICU everything was different. It was like being thrown froma secure situation to being alone. I was alone a lot. I was in a room by myself which was good- but it was like no onechecked on me. I didn’t realize how hard it was going to be to do things for myself but I had to force myself because there was no staff there to help me. Even when they did come to the room they were so busy, so rushed that it was hardto ask them questions- I’m sure there were sicker people then me. But it was a little bit like being abandoned. |
loneliness isolated, abandoned self-motivation, self-reliance inattentive abandoned, helpless, trapped |
Transcript 6– Coded
I appreciate your taking the time to speak with me. As I said before, we are interested in hearing about your experience with your recent hospitalization- what you thought worked and what you thought didn’t. Our goal is to better understand the patient experience so that we can be constantly improving.
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First, I am interested in understanding what you might think excellent care is. Can you reflect on your most recent hospitalization and share when you thought the care was excellent? This is the first time I was at this hospital and it was a different experience. Everyone was so professional- from the physicians to nurses to the nursing assistants. It was as if they really cared about who I was and what I wanted. When I came in they asked me if I wanted to wear a hospital gown or would I be more comfortable in my own clothes- have you ever heard such a thing? I of course did not want the hospital gown- I hate that feeling of flapping in the wind- it is humiliating. But right from the beginning they asked me- what was I expecting from the hospitalization. Was there anything they could do for me that would ease the experience for me? I told them – I justwant to make sure that I was not in a lot of pain. I can’t tell you how many times nurses came in and asked me about my pain. Whether it was being managed to my expectations. They included me in theconversation about how I was doing. I never suffered. Another thing that was excellent was that I rarely had to ask for information- it was routinely given. When nurses made rounds, when they came in to give medications- they were alwaysgiving me information- one nurse she explained my blood results and told me what it meant in terms of my condition- like what did it mean that my hemoglobin was going down- she explained it in relation to the bleeding I was having and how they would be watching it to see if I needed blood. I never had to ask about what was happening as it was automatically shared. That is so different- usually you have to beg to be listened to and get the information you need. |
professionalism,positive feedback appreciative, caring giving options probing` expressing emotions assessment open communication positive feedback patient education patient education open communication, patient education sense of satisfaction |
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Can you provide any examples of when you were not satisfied or not happy with the care you were receiving? Not really. But I would suggest… knock on the door before you come in- people would come into my room day and night and it feels like I was being invaded. |
lack of privacy |
Common Codes (within and across transcripts)
The Beauty of Satisfaction
The data shows that patients experienced an excellent quality of care when they felt they were being catered to…………………………………..
From the data that has been presented as per the theme, it can be said that patients felt the nurses were being accommodating, supportive, attentive and empathetic…….
The responses also revealed patients were more satisfied when they felt comfortable, understood and appreciated………..
This is evident from the patient responses, as illustrated below:
The recommendation based on the above themes ‘let me cater to you’ is improving the person centered care to the patient.
Lack of communication – It is recommended that communication with respect to physical therapy should be well scheduled and coordinated to avoid patient waiting.
Lack of privacy – The service user attending patient should introduce and be more courteous so that patient feels their privacy is maintained.
From the data that has been presented as per the theme, it can be said that patients felt knowledgeable about their health condition when they were provided with education, and given an opportunity to ask questions.
The responses also revealed patients felt the nursesadvocated for them when they…………………, which made it easier for the patients to make informed decisions.
This is evident from the patient responses, as illustrated below:
The recommendation based on the above theme ‘The three wise man’ is improving the behavior of the service user while rendering service to patient.
Lack of introduction – The service while attending the patient should introduce and develop a relation so that patient does not feel inconsiderate.
No Empathy – The service user while rendering service should develop a relation and empathise with the patient to make them comfortable.
The Power of Dissatisfaction
Just like positive experiences, negative experiences can also affect the patient’s perception of their quality of care during their hospitalization…..
From the data that has been presented as per the theme, patients who are dissatisfied express their concerns and emotions in a multitude of ways……, this leads to distrust of staff.
This is evident from the patient responses, as illustrated below:
Our recommendations for improving care:
The recommendation based on the above theme ‘the power of dissatisfaction’ is aiming to improve the satisfaction of the patient.
Information – The doctor should share the information and involve the patient in decision making with respect to surgery to empower them.
Compassionate – All service users should be compassionate like Josie so that patient feels they are cared and treated well.
From the data that has been presented as per the theme, patients felt lonely when they thought they were being ignored or abandoned by medical staff. For example, …………
The responses also revealed that patients who experienced………….., often felt trapped and helpless.
Additionally, there were some patients who replied………………
This is evident from the patient responses, as illustrated below:
Based on the above theme and coding, it is recommended that the service user should not create a situation with their act and words where the patient feel abandoned, trapped, loneliness, helplessness and ignored. They should make them feel happy, cared for, supportive, empathetic and helpful.
From the data that has been presented as per the theme, patients felt when the staff had poor communication and were impersonal, their trust decreased. For example a staff member
Additionally, there were some patientswere not dissatisfied with care due to lack of privacy and nurses were impersonal in the approach ………………
This is evident from the patient responses, as illustrated below:
Based on the above theme and coding it is recommended that the effective communication is highly important between the service user and service provider. In addition they should respect the privacy of the patient, develop the trust and promote person centered approach to improve the service and satisfaction in the hospital while providing care to the patient.
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