Patient journey mapping: the experience of patients receiving hand-injury care services in Gauteng

Abstract

Introduction Understanding the experiences of hand-injured patients accessing care is key to supporting care that is responsive to patients’ needs and achieving favourable outcomes. This study aimed to describe the journey of hand-injured patients using journey mapping to enable an in- depth understanding of patients’ experience of accessing hand-injury care services in Gauteng, South Africa. Methods A qualitative descriptive design was used. Data collection was undertaken at one private and one public healthcare facility in Gauteng. Twelve adult patients who had sustained traumatic hand injuries were recruited. Three data collection techniques were employed: a review of patients’ clinical notes, a patient journey mapping exercise, and in-depth interviews. Reflexive thematic analysis (RTA) was used, and rigour was pursued using a reflexive journal, data source triangulation, and dense description within reporting. Results Five themes were generated from the analysis: Spectrum of Satisfaction captured participants’ varying levels of satisfaction with the care they received influenced by the experience for some of medical mismanagement, inhospitable care, and the influences of COVID-19. Some participants chose to ‘turn a blind eye’ to sub-optimal features of care to focus on their recovery and some experienced the principles espoused by Batho Pele. An Emotional Journey describes the trauma associated with the hand injury, the emotional impact of the injury and loss and the need to come to terms with these. The arduous nature of long periods of healing was articulated as fatigue and the need to fight. Now everything has stopped capturing that life-changing nature of hand-injury that included a sense of dependence or aloneness, role inadequacy, caregiver or family burden, and pain. The Cost included medical and travel expenses, the role of the temporary disability grant, and the cost to the family. Finally, The Occupational Therapist captured participants’ experience of the occupational therapist as trainer and cheerleader, as well as their experience of genuine care. Conclusion Opportunities should be available for generalist occupational therapists to develop the necessary clinical competencies to respond to the needs of patients. Similar studies in other provinces are recommended. It is also recommended that all healthcare professionals offering hand-injury care services consider the psychological impact of a hand injury and refer patients for psychosocial support.