Patients with Disabilities Can Improve Doctor Communications by Describing Own Experiences

American Academy of Family Physicians

Researchers looking to better understand patient experiences are turning to patient-guided tours (PGT) of health facilities, an approach drawn from the experience-based design literature. However, little research has assessed how patients with disabilities perceive the approach. In this qualitative study, 18 patients were asked to walk through the clinic as they would on a typical visit while describing their experiences. Patients' experiences and perceptions of the tours were audiotaped and transcribed. Additionally, investigators took field notes and completed thematic content analyses.

Their findings support the value of PGT methodology in understanding the experiences of patients with disabilities in the clinic setting. Patients reported that walking through the facility elicited experiences that participants said they would not have recalled using other research methods. They also reported feeling empowered when leading investigators through the clinic space and guiding researchers to "see through their eyes." Patient-guided tours encouraged patients to be active participants, which increased their comfort levels and sense of collaboration with the medical team. However, patient-guided tours may exclude patients who have severe disabilities.

What We Know: Researchers striving to improve patient experiences are moving away from the traditional measurements of patient satisfaction (such as surveys or focus groups) to newer strategies. Exploring patient experiences can lead to better patient-provider communication and promote a more collaborative health care approach. Implementing a patient-centered approach, however, requires system-level changes and shared decision making.

What This Study Adds: Through the use of patient-guided tours, researchers gained a greater understanding of the experiences of patients with disabilities in the clinic setting and showed that these tours are a valuable tool to measure in-clinic experiences by patients with disabilities.

Patient Guided Tours: A Patient-Centered Methodology to Understand Patient Experiences of Health Care

Sakina Walji, MD, CCFP, MPH, and June Carroll, MD, CCFP, FCFP

Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, and Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada

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