Tools to discover and co-design ideal care experiences

Abstract

Shadowing a patient through a care experience can provide perspectives not usually seen in care delivery systems or discrete experiences. Critics of shadowing often point to the time involved to effectively shadow and create reports as a reason not to use the practice. goShadow is a smartphone and web-based app tool that simplifies the collection and aggregation of shadowing data. goShadow provides users with the ability to concurrently time multiple events, tasks, people, and places, record notes with time stamps, and export automated and easily digestible reports. BACKGROUND As healthcare systems evolve, the voice of the patient (and family) is often lost in the pursuit of growth and expansion. Process inefficiencies and gaps in patient care are continually identified; verifying and addressing those issues can be burdensome and time consuming. Providers are siloed in their piece of each experience: they interact with patients in very specific situations without seeing the full episode of care. Despite the U.S.-based Institute of Medicine identifying patient-centredness as one of the six essential components to delivering high-quality care, there is little consensus on how to conceptualize, interpret, or administer patient-centered care. Clinicians, patients, and families need a structured and organised method to capture qualitative and quantitative factors, as well as the more subtle feelings and impressions that comprise the care experience from the patient’s point of view. The lack of understanding of the entire patient experience, from beginning to end, can have an enormous impact on the quality of care that the patient receives and on the quality of experience that is reported by the patient anecdotally through surveys and patient-reported outcomes. Shadowing, or the real-time observation of patients and families through a care experience, is one way to bridge these gaps. Yanes et al assert that observations of patient experiences are informative and cost effective, and so they are an important tool for healthcare improvement. Patient and family observations, along with traditional assessment methods, contribute to a comprehensive understanding of complex care systems. Using the shadowing methodology to map the current state of care from the patient’s perspective is critical to identifying inefficiencies that might not be obvious to care providers and administrators. Using current state mapping coupled with time studies and opportunity reports, hospitals, healthcare organisations, and medical practices