Organizational and service management interventions for improving the patient experience with care

Abstract

BACKGROUND: Healthcare managers and administrators increasingly need to develop systems, structures and operations capable of improving the patient experience performance of their organisations or service delivery units.

AIM: To systematically review the effectiveness of organizational and service management interventions on standardized patient experience measure scores.

METHODS: Six scientific databases, speciality journals and snowballing were used to identify English-language, peer-reviewed, contemporary studies (2015-2023) that examined the impact of service management or organizational interventions on the patient experience as a primary outcome. The studies needed to include inferential statistics on standardized, patient-reported experience measures. Two independent reviewers performed the eligibility decisions and risk-of-bias appraisals.

RESULTS: Nine papers were finally included. Three papers were on discrete, service-level interventions, including two randomized controlled trials (RCTs) and one pre-post study; one RCT achieved significant improvements by delaying the timing of bedside rounding versus maintaining the early morning schedule. One non-randomized controlled study and two pre-post studies addressed organisation-wide approaches. Among those, one pre-post study achieved significant improvements by having site managers meet regularly with an organizational oversight committee to compare the units' patient-experience performance and setting improvement expectations. Finally, three observational, multi-site comparative studies were included. These addressed self-reported improvement approaches, implementation of a nursing excellence certification programme, and implementation of Patient Experience Offices. The latter was significantly associated with improved patient experience performance.

CONCLUSION: Selected discrete service-level interventions and organizational approaches can lead to better patient experience outcomes, even though the evidence from the pre-post and observational studies should be interpreted with caution.