The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates

With the emergence of the coronavirus (COVID-19) pandemic in the United States in early 2020, hospitals across the country made the difficult decision to alter visitation policies, by either limiting visitations or restricting visitations altogether by closing access to family, friends and care part...

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Autores principales:	Geoffrey Silvera, Jason Wolf, Anthony Stanowski, Quint Studer
Formato:	article
Lenguaje:	EN
Publicado:	The Beryl Institute 2021
Materias:	visitation patient experience patient safety hcahps ahrq covid-19 subjective advocate Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4111de89149b494d99d9c8a9f2aef816
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id	oai:doaj.org-article:4111de89149b494d99d9c8a9f2aef816
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	visitation patient experience patient safety hcahps ahrq covid-19 subjective advocate Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	visitation patient experience patient safety hcahps ahrq covid-19 subjective advocate Medicine (General) R5-920 Public aspects of medicine RA1-1270 Geoffrey Silvera Jason Wolf Anthony Stanowski Quint Studer The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates
description	With the emergence of the coronavirus (COVID-19) pandemic in the United States in early 2020, hospitals across the country made the difficult decision to alter visitation policies, by either limiting visitations or restricting visitations altogether by closing access to family, friends and care partners in an effort to reduce further spread of the virus. While there is foundational research on the impact of family and care partner presence on the experience of patients and patient safety outcomes, the actions driven by the pandemic allowed for a real-time comparison of the impact of family or care partner presence or lack thereof. Patient and family engagement has long been a part of patient experience scholarship where the role of family members and care partners as patient advocates and a presence of support has been reinforced. Scholarship and practice have also encouraged movement from restricted visiting hours to having open visitation based on findings that, in addition to better patient outcomes, there is a benefit in nurse job satisfaction and communication when visitations are unrestricted. The purpose of this study is to examine the degree to which hospital visitation restrictions in U.S. hospitals during the COVID-19 pandemic help to explain changes in patient experience and patient safety outcomes. To examine this relationship, patient experience and safety outcomes of a national sample of hospitals (n=32) during the pandemic is compared to previous corresponding performance. The results indicate that hospital performance was negatively impacted on average during the pandemic for hospitals in the sample. However, differences in hospital performance during the pandemic were driven by hospitals that disallowed patient visitations. Hospitals with closed visitations saw most pronounced deficits in their performance with regard to patient ratings of medical staff responsiveness, fall rates and sepsis rates. Performance in hospitals that either remained unrestricted or partially limited their visitations was not appreciably different from pre-pandemic performance, and in some cases performance even improved marginally. The findings of this study indicate that the policy to allow for visitors, or subjective advocates, individuals with a vested interest in the well-being of the patient, is beneficial not only for the patient, but also in sustaining high quality of care. Recommendations are given for how hospitals might achieve improved quality and safety outcomes even in instances when organizations believe visitation needs to be disallowed or restricted. The results of this study suggest those decisions should be made with great care and in only the most extreme circumstances. <strong>Experience Framework</strong> This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (<a href="https://www.theberylinstitute.org/ExperienceFramework">https://www.theberylinstitute.org/ExperienceFramework</a>). <ul> <li><a href="https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Patient%2C%20Family%20%26%20Community%20Engagement%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D">Access other PXJ articles</a> related to this lens.</li> <li><a href="https://www.theberylinstitute.org/page/Ecosystem-PatientFamilyCommunityEngagement">Access other resources</a> related to this lens.</li> </ul>
format	article
author	Geoffrey Silvera Jason Wolf Anthony Stanowski Quint Studer
author_facet	Geoffrey Silvera Jason Wolf Anthony Stanowski Quint Studer
author_sort	Geoffrey Silvera
title	The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates
title_short	The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates
title_full	The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates
title_fullStr	The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates
title_full_unstemmed	The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates
title_sort	influence of covid-19 visitation restrictions on patient experience and safety outcomes: a critical role for subjective advocates
publisher	The Beryl Institute
publishDate	2021
url	https://doaj.org/article/4111de89149b494d99d9c8a9f2aef816
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spelling	oai:doaj.org-article:4111de89149b494d99d9c8a9f2aef8162021-11-15T04:33:47ZThe influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates2372-0247https://doaj.org/article/4111de89149b494d99d9c8a9f2aef8162021-04-01T00:00:00Zhttps://pxjournal.org/journal/vol8/iss1/5https://doaj.org/toc/2372-0247With the emergence of the coronavirus (COVID-19) pandemic in the United States in early 2020, hospitals across the country made the difficult decision to alter visitation policies, by either limiting visitations or restricting visitations altogether by closing access to family, friends and care partners in an effort to reduce further spread of the virus. While there is foundational research on the impact of family and care partner presence on the experience of patients and patient safety outcomes, the actions driven by the pandemic allowed for a real-time comparison of the impact of family or care partner presence or lack thereof. Patient and family engagement has long been a part of patient experience scholarship where the role of family members and care partners as patient advocates and a presence of support has been reinforced. Scholarship and practice have also encouraged movement from restricted visiting hours to having open visitation based on findings that, in addition to better patient outcomes, there is a benefit in nurse job satisfaction and communication when visitations are unrestricted. The purpose of this study is to examine the degree to which hospital visitation restrictions in U.S. hospitals during the COVID-19 pandemic help to explain changes in patient experience and patient safety outcomes. To examine this relationship, patient experience and safety outcomes of a national sample of hospitals (n=32) during the pandemic is compared to previous corresponding performance. The results indicate that hospital performance was negatively impacted on average during the pandemic for hospitals in the sample. However, differences in hospital performance during the pandemic were driven by hospitals that disallowed patient visitations. Hospitals with closed visitations saw most pronounced deficits in their performance with regard to patient ratings of medical staff responsiveness, fall rates and sepsis rates. Performance in hospitals that either remained unrestricted or partially limited their visitations was not appreciably different from pre-pandemic performance, and in some cases performance even improved marginally. The findings of this study indicate that the policy to allow for visitors, or subjective advocates, individuals with a vested interest in the well-being of the patient, is beneficial not only for the patient, but also in sustaining high quality of care. Recommendations are given for how hospitals might achieve improved quality and safety outcomes even in instances when organizations believe visitation needs to be disallowed or restricted. The results of this study suggest those decisions should be made with great care and in only the most extreme circumstances. <strong>Experience Framework</strong> This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (<a href="https://www.theberylinstitute.org/ExperienceFramework">https://www.theberylinstitute.org/ExperienceFramework</a>). <ul> <li><a href="https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Patient%2C%20Family%20%26%20Community%20Engagement%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D">Access other PXJ articles</a> related to this lens.</li> <li><a href="https://www.theberylinstitute.org/page/Ecosystem-PatientFamilyCommunityEngagement">Access other resources</a> related to this lens.</li> </ul>Geoffrey SilveraJason WolfAnthony StanowskiQuint StuderThe Beryl Institutearticlevisitationpatient experiencepatient safetyhcahpsahrqcovid-19subjective advocateMedicine (General)R5-920Public aspects of medicineRA1-1270ENPatient Experience Journal (2021)

The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates

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