3072 — Use of a novel method for measuring the patient experience: Results of guided tours with Veterans and employees/providers

Locatelli SM, Hines VA Hospital Health Services Research & Development; Turcios S, Hines VA Hospital Health Services Research & Development; LaVela SL, Hines VA Hospital Health Services Research & Development; Northwestern University Feinberg School of Medicine;

Objectives:
The movement toward patient-centered care requires changes throughout the health care system, and care organizations must rethink their approach to performance/quality measurement, incorporate patient experience into evaluation, and encourage providers/employees to understand patients' perspectives, values, and preferences. The purpose of this manuscript is to demonstrate a novel method of measuring the patient's experience (i.e., guided tours) and assess concordance in patient and provider views.

Methods:
Guided tours were conducted with Veterans and employees/providers at two VA facilities. Veterans were asked to walk through the hospital as they would on "a typical visit" and employees/providers as though they were a Veteran patient. Each individual was asked to narrate thoughts and feelings as they walked. Tours were audio-recorded, transcribed, and analyzed using qualitative content analysis.

Results:
Though both Veterans (n = 30) and employees/providers (n = 25) commented on physical aspects of the environment, Veterans also looked deeper at social factors that make an environment comfortable and welcoming. Wait times were a frequent topic of discussion with Veterans, who described contextual factors that contributed to long waits, such as limited control over appointment scheduling. However, both groups considered short wait times to be part of the "ideal" experience. While few Veterans reported receiving care outside of VA, both Veterans and employees/providers contrasted VA and non-VA care, in terms of available resources, wait times, and social atmosphere.

Implications:
This study demonstrates the importance of obtaining multiple perspectives. Conducting tours with both Veterans and employees/providers allowed us to understand the care process and identify areas for improvement, such as additional resource needs, and improvements to wait times and appointment scheduling. Data derived offered rich feedback on preferences for care delivery.

Impacts:
By touring the environment with an evaluator, participants are able to share and recall reactions, and give real-time feedback more easily than through surveys. Guided tours can generate rich data, and could become an internal tool to measure performance and improve the patient experience.