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Preparation for cardiac procedures: identifying gaps between outpatients' views and experiences of patient-centred care

Fakes, K.; Williams, T.; Collins, N.; Boyle, A.; Sverdlov, A. L.; Boyes, A.; Sanson-Fisher, R. W.

2023-02-23 health systems and quality improvement
10.1101/2023.02.22.23286327 medRxiv
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BackgroundTo examine the delivery of patient-centred care and identify any gaps in care perceived as essential by patients; this study examined outpatients: 1) views on what characterises essential care and 2) experiences of care received, in relation to cardiac catheterisation and subsequent cardiovascular procedures. MethodsA cross-sectional descriptive study was undertaken. Surveys were posted to outpatients who had undergone elective cardiac catheterisation in the prior six months at an Australian tertiary public hospital. Participants completed a 65-item survey to determine: a) aspects of care they perceive as essential for a healthcare team to provide to patients receiving care for a cardiac condition (Important Care Survey); or b) their actual care received (Actual Care Survey). Numbers and percentages were used to calculate the most frequently identified essential care items by patients; and the experiences of care received. Items rated as either Essential or Very important by at least 80% of participants were determined, reflecting patient endorsement of the importance of the component of care. A gap in patient-centred care was identified as being any item that was endorsed as essential/very important by 80% or more of participants but reported as received by less than 80% of participants. ResultsOf 582 eligible patients, 264 (45%) returned a completed survey. 43/65 items were endorsed by over 80% of participants as essential/very important. Of those, for 22 items, less than 80% of respondents reported the care as received. Gaps were identified in relation to GP consultation (3 items), preparation (4 items), having the procedure (2 items), follow-up care (1 item), subsequent decision making for treatment (4 items), prognosis (6 items) and post-treatment follow-up (1 item). ConclusionsAreas were identified where actual care fell short of patients perceptions of essential care, particularly general practitioner involvement, the referral process and information on patient prognosis.

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