Patient shadowing as a simple but effective tool to improve the patient experience
UBC graduate Sylvia Xia with Duncan Steele, an alumnus from the MHA program, now working as a system-level ethicist with Fraser Health Ethics Services.
Acknowledging patient wait times, using visual aids to explain a test result, and other small gestures can have a big impact for patients visiting an emergency department.
That’s what November graduate Sylvia Xia found in her capstone project for the Master of Health Administration degree at the School of Population and Public Health. Using ‘patient shadowing’, Miss Xia’s project explored the patient experience at an emergency department, and how healthcare providers can be engaged while empowering patients.
What is ‘patient shadowing’ and how does it fit into patient-centered care?
Patient-centered care is important because of its links to improved patient experience, safety, outcomes, and more. As a tool, patient shadowing is as patient-centered as it gets – you’re literally following the patient and experiencing the care provided alongside them. The project was a pilot involving seven front line health care providers ‘shadowing’ 13 patients for four hour sessions in the emergency department of Burnaby Hospital earlier this year, recording their observations and later providing ideas for improvement of care. Although small in scope, the initiative was effective and produced important information.
What was surprising was the amount of benefits from patient shadowing on all levels: patients could provide feedback about their experience, and health care providers were engaged in care re-design while being introduced to a different hospital unit and its work. Health care workers and management can sometimes make assumptions about how care is being delivered – shadowing lets you see from the patient perspective whether these are accurate or not.
Why do the little things matter when it comes to hospital care?
Nobody wants to be in a hospital, and it’s understandable that patients want to feel looked after and cared for. Most are aware that there are other more urgent cases and didn’t mind the wait itself. At the root of much patient discontent were issues that can be easily solved with improved communication, such as wait acknowledgment, staff introductions, updates on the situation, and explanations of procedures.
In the project, we found that some clinicians were excellent in using visual aids to help better explain ideas to patients. These ‘little things’ can go a long way when it comes to improving a potentially frustrating ER visit, and patients remember these acts with gratitude.
What have been the outcomes of your project?
The management at the Burnaby Hospital Emergency Department’s support and receptiveness meant that the results were immediately fed back to the staff and unit. Project participants, and myself, also encountered the more emotional, empathy-promoting side of shadowing, as we were reminded of some of the key reasons that compelled us to enter health care professions in the first place.
As for the pilot itself, Fraser Health is committed to patient experience and there is ongoing discussion about how it can be transitioned to a sustainable program – so far, it seems promising.
What has been the most enjoyable part of your UBC experience?
The people. UBC has a very talented and diverse student population and I learned immensely from all of my classmates, knowledge which I will carry forward into my career. The program faculty and management have also been helpful and supportive.
What do you hope to do in the future?
I hope to continue learning about how patients can be better advocated for, and apply those practices into my future work, whether clinically or in management.