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Exploring patient strategies in response to untoward healthcare encounters

机译:探索患者应对不良医疗保健的策略

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摘要

Background: Increasing attention to patients’ rights and their ability to choose their healthcare provider have changed the way patients can respond to untoward, disempowering and abusive healthcare encounters. These responses are often seen as crucial for quality improvement, yet they are little explored and conceptualized. Objective: To explore patients’ potential responses to untoward healthcare encounters and looking at their possible consequences for care quality improvement as well as for the individual patient. Research design: The article is structured looking at two primary strategies: patient exit (leaving a healthcare provider) and patient voice (expressing grievances), derived from Hirschman (1970). These strategies were explored by the use of theoretical and empirical literature and applied to an individual patient case. The case functions as a pedagogical tool to illustrate and problematize what exit and voice strategies can mean for a single patient. Ethical considerations: The patient case is my version of a generalized scenario that is described elsewhere. It does not represent an individual patient’s story, but aims to be realistic and recognizable. Findings and conclusion: Based on the existing literature, it is hypothesized that, in their current form, exit and voice strategies have a limited effect on care quality and can come at a price for patients. However, both strategies may be of value to patients and providers. Therefore, the healthcare system could empower patients to engage in action and could further develop ways for providers to effectively use patients’ responses to improve practice and find ways to prevent patients from untoward experiences in healthcare.
机译:背景:对患者权利及其选择医疗保健提供者的能力的日益关注,已经改变了患者应对不良,无能为力和滥用医疗经历的方式。这些响应通常被认为对提高质量至关重要,但是很少进行探索和概念化。目的:探讨患者对不良医护人员的潜在反应,并探讨他们可能对改善护理质量以及对个别患者造成的后果。研究设计:本文着眼于两种主要策略:从Hirschman(1970)派生的患者退出(离开医疗保健提供者)和患者的声音(表达不满)。通过使用理论和经验文献探索了这些策略,并将其应用于单个患者案例。该案例用作教学工具,用于说明和解决单个患者的退出和发声策略可能意味着什么。伦理考虑:患者案例是我在其他地方描述的广义方案的版本。它并不代表每个患者的故事,而是旨在求实和可识别。结果与结论:根据现有文献,假设以目前的形式,退出和发出声音的策略对护理质量的影响有限,并且可能会给患者带来代价。但是,这两种策略都可能对患者和提供者有价值。因此,医疗保健系统可以使患者有能力采取行动,并可以进一步开发提供者有效利用患者反应来改善实践的方法,并找到防止患者在医疗保健方面经历不良经历的方法。

著录项

  • 作者

    Brüggemann, Jelmer;

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  • 年度 2017
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  • 原文格式 PDF
  • 正文语种 eng
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