Jack Iwashyna 🫁Dec 21, 2022

#HSR as field – and as
@VAhsrd@twitter
– have spent 40 years obsessing about barriers to #accessTOcare

I would think “what are the tasks a patient needs to accomplish to access care” would have been a foundational question somebody identified and answered

But I can't find it. Everything seems to be #ProcessMaps from a health system perspective, or #Aday/Anderson too high abstraction

help?

@Janekohara, can I consult you? If that is rude, please ignore me?

Show threadJane K. O'HaraDec 21, 2022

@iwashyna this is such an interesting question. I expect work has been done perhaps for specific conditions (I'm thinking especially cancer, for example). But with regards to safety, almost all mapping from a patient point of view happens - albeit this is still rare - within acute settings.

We did a FRAM of the transitional process from acute to 30 days post transmission: https://www.sciencedirect.com/science/article/abs/pii/S0003687020300168?via%3Dihub

Show threadMichael Anne KyleDec 22, 2022
@Janekohara @iwashyna here is a process mapping paper on metastatic breast cancer that I particularly like (most of these types of papers don’t include work at home) https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.3461
Show threadMichael Anne KyleDec 22, 2022
@Janekohara @iwashyna a med soc perspective that I also particularly like https://pubmed.ncbi.nlm.nih.gov/31227211/
From boundary object to boundary subject; the role of the patient in coordination across complex systems of care during hospital discharge - PubMed

Advocates for patient involvement argue that seeking the active contribution of patients and families in the coordination of care can help mitigate system complexity, and lead to improvements in quality. However, sociological and organisational research has identified barriers to involving patients …

PubMed
Show threadMichael Anne KyleDec 22, 2022
@Janekohara @iwashyna will pause here but lastly jennifer Wolff has many papers on informal caregiving that indirectly capture patient-facing work
Show threadJane K. O'Hara

@michaelannica @iwashyna

Thanks for all these great links 😊

Dec 22, 2022 at 2:51pmWeb
Show threadJack Iwashyna 🫁Dec 22, 2022

@michaelannica @Janekohara

You both are the best! Thank you

(And #GoMastodon)

Show threadJane K. O'HaraDec 22, 2022

@iwashyna @michaelannica

You are most welcome 😊