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What can trauma patients' experiences and perspectives tell us about the perceived quality of trauma care? A qualitative study set within the UK National Health Service

Kellezi, Blerina; Earthy, Sarah; Sleney, Jude; Beckett, Kate; Barnes, Jo; Christie, Nicola; Horsley, Daniel; Jones, Trevor; Kendrick, Denise

Authors

Blerina Kellezi

Sarah Earthy

Jude Sleney

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Kate Beckett Kate2.Beckett@uwe.ac.uk
Occasional Associate Lecturer - Allied Health Professions

Jo Barnes

Nicola Christie

Daniel Horsley

Trevor Jones

Denise Kendrick



Abstract

The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring 'good quality care'. However, such frameworks lack a systematic or meaningful definition of what 'good quality care' means from the patients' perspective. The present research provides an in -depth analysis of patients' experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16-70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants' interaction with different service providers) defined the care experience and the value of being 'cared for'. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying 'their best' despite constrains of current care, having their emotional needs recognised and addressed and staff competence. Patients reported also poor quality of care and 'not being cared for' by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of quality care with implications for their recovery. The findings have implications for quality frameworks and theoretical definitions of quality of care; they demonstrate the importance of patient experience in addition to clinical effectiveness and safety as an essential dimension of quality care. In terms of practice, the findings support the need to incorporate knowledge and training of injured adults' psychological needs, and the value of interaction with professionals as a patient defined dimension of the quality of care.

Citation

Kellezi, B., Earthy, S., Sleney, J., Beckett, K., Barnes, J., Christie, N., …Kendrick, D. (2020). What can trauma patients' experiences and perspectives tell us about the perceived quality of trauma care? A qualitative study set within the UK National Health Service. Injury, 51(5), 1231-1237. https://doi.org/10.1016/j.injury.2020.02.063

Journal Article Type Article
Acceptance Date Feb 12, 2020
Online Publication Date Feb 13, 2020
Publication Date May 1, 2020
Deposit Date May 28, 2021
Journal Injury
Print ISSN 0020-1383
Electronic ISSN 1879-0267
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 51
Issue 5
Pages 1231-1237
DOI https://doi.org/10.1016/j.injury.2020.02.063
Public URL https://uwe-repository.worktribe.com/output/5383926