Organizational and service management interventions for improving the
patient experience with care: systematic review of the effectiveness.
Abstract
Background: Healthcare managers and administrators increasingly
need to develop systems, structures, and operations capable of improving
the patient experience performance of their organizations or service
delivery units. Aim: To systematically review the effectiveness
of organizational and service management interventions on standardized
patient experience measure scores. Methods: Six scientific
databases, specialty journals, and snowballing were used to identify
English-language, peer-reviewed, contemporary studies (2015-2023) that
examined the impact of service management or organizational
interventions on the patient experience as a primary outcome. The
studies needed to include inferential statistics on standardized,
patient-reported experience measures. Two independent reviewers
performed the eligibility decisions and risk-of-bias appraisals.
Results: Nine papers were finally included. Three papers were
on discrete, service-level interventions, including two randomized
controlled trials (RCTs) and one pre-post study; one RCT achieved
significant improvements by delaying the timing of bedside rounding
versus maintaining the early morning schedule. One non-randomized
controlled study and two pre-post studies addressed organization-wide
approaches. Among those, one pre-post study achieved significant
improvements by having site managers meet regularly with an
organizational oversight committee to compare the units’
patient-experience performance and setting improvement expectations.
Finally, three observational, multi-site comparative studies were
included. These addressed self-reported improvement approaches,
implementation of a nursing excellence certification program, and
implementation of Patient Experience Offices. The latter was
significantly associated with improved patient experience performance.
Conclusion: Selected discrete service-level interventions and
organizational approaches can lead to better patient experience
outcomes, even though the evidence from the pre-post and observational
studies should be interpreted with caution.