Introduction: The Chronic Care Model (CCM), the Expanded Chronic Care Model (ECCM) and the eHealth Enhanced Chronic Care Model (eCCM) focus on how healthcare teams and eHealth support can offer effective care and relevant solutions for patients facing chronic care conditions. However, they do not consider how patients can help these teams in their work, nor do they promote ways in which patients can help themselves. However, in the last decade, three different models have emerged that can complete our capacity to design and deliver integrated care for people with chronic diseases. In this article, we propose a revised version of the model that integrates the patient perspective and patients' experience‐based knowledge. It integrates three different ways of engaging patients that complement the other patient engagement point of view: the experience of care and mediation in healthcare, therapeutic patient education and patient learning pathways, as well as patient–professional partnership.Methodology: For each of the three models, we conducted a review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct and government reports on patient engagement and partnership with their healthcare providers, to integrate the different components of these models into the ECCM and eCCM. The goal is to create a model that better takes into account the experiential knowledge of patients and citizens throughout its different dimensions.Results: We identified 129 papers based on their framework, design, sample, measures and fit with patient engagement and chronic illness and added our own research when relevant. Integrating the three models provides an opportunity to amplify the role played by the patient perspective in the management of chronic disease. The Expanded Chronic Care Patient–Professional Partnership Model (E2C3PM) is intended to rebalance power relations between healthcare professionals and patients (and their caregivers). This new model is based on recognizing patients' experiential knowledge and their roles as caregivers and as full members of the care team. Integrating patient empowerment into the E2C3PM underscores the importance of coproduction care with patients at the clinical, organizational and system levels within a supportive environment.Conclusion: Applying this new model should make it possible to better take into account the complexity of chronic diseases, improving the integration not only of care, services and eHealth support but also the various determinants of health and reaching a mutually beneficial settlement among all actors involved.Patient or Public Contribution: A patient‐researcher contributed to the development of the protocol, the data collection and the preparation and writing of this manuscript.
The growing interest in hospital users’ complaints appears to be consistent with recent changes in health care, which considers the patient’s voice a valuable information source to improve health care. Based on the assumption that the clinicians’ lived experience is an essential element of health care and to neglect it may have serious consequences, this study aimed to explore how physicians experience hospital users’ complaints and the associated mediation process. A qualitative analysis of experience narrative interviews. Fourteen physicians concerned by complaints which resulted in a mediation provided a comprehensive narrative of their experience with the complaints center. Data were analyzed with Interpretative Phenomenological Analysis (IPA). Interviews were analyzed inductively and iteratively to explore how physicians make sense of their experience. The analysis of the physicians’ narratives revealed that being the object of a complaint and to enter a process of mediation is a specific experience of which some physicians benefited and others felt psychologically weakened. The causes of the complaints were at times considered by physicians to be related to medical malpractice, but more often to communicational and relational difficulties, unrealistic expectations of patients, physicians’ attitudes, or the lack of a coherent care plan. The analysis of their narratives revealed that physicians showed a need for reconsidering and elaborating on the reason(s) leading to the complaint, and on the expectations patients/relatives may have had towards medicine and health care professionals. This may be interpreted as an attempt to assign their meaning, such meaning having the potential to ease the distress associated with the experience of complaints. Most physicians appeared more aware of the communicational and relational aspects of care after experiencing a complaint situation; however, prior to the complaint, physicians seem to have underestimate these issues, and when they acknowledge that the complaint originated in psychological aspects of care, they still consider it not relevant, since not related to clinical decision-making and management. Mediation as providing the opportunity to restore the clinical relationship should be encouraged at an institutional level as well as support of health care professionals by means of individual or group supervision.
Purpose: Cancer care is undergoing a conceptual shift with the introduction of the principles of patient-centered care to support patients’ individual needs. These needs include those related to hospitality during cancer treatments. This paper aims to provide an extension of the supportive care framework by bringing in the hospitality approach inspired by the hotel industry. Method: The “Lausanne Hospitality Model,” integrating hospitality into supportive care, was developed through an iterative process, combining expertise in supportive care and health services research, communication, and the hotel industry. Results: This conceptual paper integrates hospitality and service sciences into the supportive care framework. The “Lausanne Hospitality Model” offers new insights into the notions of cancer journey, patient experience, services, and practices that may be involved when facilitating hospitality. While most concepts used in the model are based on prior research, they have not been combined previously. The model highlights the place of hospitality in the patient’s experience within cancer services and, by extension, its role in professional practice. Conclusion: Practices involved in the delivery of cancer care need to reinforce the importance attributed to hospitality services, as they impact patients’ experiences. By integrating the hospitality perspective into healthcare delivery and supportive care, this paper addresses previously theoretically overlooked aspects that impact patients’ experiences during cancer care.
Background: Patients’ and relatives’ feedback is used by hospitals to improve the quality and safety of care. It can be solicited, as in the case of satisfaction questionnaires or complaints collected by mediation centers. Hospital users also provide unsolicited feedback by writing compliment letters, which are generally considered as expressions of gratitude. This study investigated compliment letters received by a neonatology service from parents with a twofold objective: first, to investigate compliment letters’ content regarding parents’ experiences and second, to explore underlying needs that motivated parents to provide feedback. Methods: This qualitative descriptive study was based on the analysis of 573 compliment letters collected by the neonatology service of Lausanne University Hospital in Switzerland between 2009 and 2020. The parents’ lived experiences contained in compliment letters were analyzed using framework analysis. The needs and functions that their feedback fulfilled were examined through a custom analysis method, combining psychological and socio-anthropological perspectives, and informed by the results of the framework analysis. Results: Five core themes characterized parents’ experiences: recall of the care and hospital stay (contextual information to refer to the children’s stays in the service), life after the hospital discharge (children’s health evolution and development), parents’ feelings (how parents experienced their children’s care), perception of the healthcare professionals (healthcare professionals ways of being and doing), parents’ gratitude (thanks to healthcare professionals for their acts or their qualities). Five underlying needs were identified: thanking the team, closure (claim that the children were no longer patients), partial closure (feedback on the state of the children), taking its own place in the care (parent’s account of the impact of children’s hospitalization), managing the sense of indebtedness (parents’ acknowledgement that they owe something to the team). Conclusion: When parents write compliment letters, they mostly express how they experienced their children’s hospitalization and how they managed to make sense out of it. Compliment letters thus have other functions than expressing gratitude. They allow parents to sustain relationships with healthcare professionals, support the normalization of their children’s situation and their recovery or provide testimony of experiences. They contain important information about the writers, health care professionals, the relationship they have established, hospital operations and healthcare organization. As hospital users' experiences are thought to contribute to health care quality, it matters that health services consider the information they convey.