Table 3. Patient-Perceived Breakdowns Categorized Using the Patient Experience Coding Tool.
Type of Patient-Perceived Breakdown | Overall (n=979) |
---|---|
Admission Process | |
Delay or long wait on admission | 90 (9.2) |
| |
Diagnosis | |
Diagnosis delayed, no diagnosis; conflicting diagnoses; misdiagnosis | 33 (3.4) |
| |
Testing | |
Desired testing not offered/not available/denied/delayed | 21 (2.1) |
| |
Treatments (other than medication), Procedures, Surgery | 34 (3.5) |
| |
Desired treatment (other than medication) not provided; treatment provided too aggressive, not sufficiently aggressive; not given appropriate treatment | 13 (1.3) |
| |
Problems with procedures | 11 (1.1) |
| |
Unexpected or suboptimal surgical outcome (other than infection); patient believes surgery may have been/was performed poorly, or unnecessarily delayed | 4 (0.4) |
| |
Infection | 7 (0.7) |
| |
Medication-Related | 120 (12.3) |
| |
Untreated/inadequately treated pain | 55 (5.6) |
| |
Untreated/inadequately treated side effects | 8 (0.8) |
| |
Problems with WHAT medications prescribed; available | 56 (5.7) |
| |
Problems with medication administration | 19 (1.9) |
| |
Access and Relationship | 100 (10.2) |
| |
No/suboptimal access to particular provider or type of providers; insufficient time with provider(s) | 44 (4.5) |
| |
Rude, cold, or uncaring, manner; dismissive of patient's concerns; patient preferences ignored or discounted; providers seemed not to know the patient, the patient's case, history, or needs | 62 (6.3) |
| |
Information Exchange | 158 (16.1) |
| |
Insufficient or inaccurate information; information not provided when needed/wanted | 105 (10.7) |
| |
Patient given confusing information, or too much information | 6 (0.6) |
| |
Patient report of problems, side effects ignored or discounted; patients attempts to correct provider understanding ignored | 27 (2.8) |
| |
Difficulty getting questions answered; request for information ignored; phone calls not returned or not returned in a timely manner | 32 (3.3) |
| |
Poor communication; not listening, not further specified | 26 (2.7) |
| |
Language/Accent | 12 (1.2) |
| |
Patient/family unable to communicate to providers due to patient/family language | 2 (0.2) |
| |
Patient/family members had difficulty understanding providers due to providers' accent or language | 10 (1.0) |
| |
Nursing Care and Responsiveness | 63 (6.4) |
| |
Nurses or staff unresponsive to calls, alarms, immediate patient needs | 36 (3.7) |
| |
Problems with nursing care (IVs, dressings, toileting, feeding) | 37 (3.8) |
| |
Team Communication | 65 (6.6) |
| |
Providers not communicating with each other; unaware of what others had done; conflicting opinions; kept changing things; not on the same page | 65 (6.6) |
| |
Discharge | 56 (5.7) |
| |
Delay in discharge | 11 (1.1) |
| |
Premature discharge | 16 (1.6) |
| |
Problems with discharge arrangements | 18 (1.8) |
| |
Insufficient or inaccurate discharge information, including delayed notification of family | 18 (1.8) |
| |
Other | 55 (5.6) |
| |
Medical error or near miss suspected | 5 (0.5) |
| |
Problems with appropriate diet, or fluids related to orders | 16 (1.6) |
| |
Other concerns or problems not categorized above | 34 (3.5) |
| |
Associated Harm | 140 (14.3) |
| |
Physical harm or harm to health | 66 (6.7) |
| |
Needed additional care | 15 (1.5) |
| |
Damaged relationship with doctors or nurses | 28 (2.9) |
| |
Disruption to patient's or family member's life | 15 (1.5) |
| |
Emotional harm or distress | 60 (6.1) |
| |
Financial costs to patient | 6 (0.6) |
Because multiple codes could be applied to one interview, the numbers of problems in sub-categories do not always sum to the total for a given category.