Deficits in the Healthcare System Revealed Through Patient Shadowing

Taylor Gauss and Madalyn Scheerhorn

Authors:  Taylor Gauss, Madalyn Scheerhorn, Frank Holcomb, Jacqueline Baron-Lee, Katharina Busl

Faculty Mentor:  Katharina Busl

College:  College of Medicine


Patient shadowing evaluates the patient’s experience through personal insight into their encounters within the clinical setting to increase patient satisfaction and improve areas of weakness within the clinical setting. For ten months, 204 undergraduate interns were able to patient shadow through the assessment of the STEEP model which stands for Safety, Timeliness, Effectiveness, Efficiency, and Patient-Centeredness of the patient experience. These were performed at the Fixel Institute, the Neurology Clinic within the Medical Plaza, and the Neuromedicine Clinic within the Heart and Vascular Medicine Hospital through the UF Health system at Shands Hospital in Gainesville, Florida. We found that the average provider encounters were significantly higher within the Fixel Institute and the Neurology Medical Plaza as supposed to the Neuromedicine Clinic. We also found that hand hygiene amongst providers was higher within the Fixel Institute and the Neuromedicine Clinic as supposed to the Neurology Medical Plaza. To improve these discrepancies, there are opportunities for staff education on proper hand hygiene as well as reevaluating clinic schedules to increase encounter times.

Poster Pitch

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11 Responses
  1. Awesome project! Were these participants in some sort of course where they were able to join in on the project? Also, I couldn’t reference the poster (because it’s difficult to see on my end) but when it comes to hand-hygiene, couldn’t it also be possible that all the physicians are sanitizing/washing their hands enough times to be clean/safe, but just washing their hands differently between institutions. I wasn’t sure if you took that into account. For example, I could wash my hands ten times a day but my friend 40 times. We could both have clean hands, but he just washes it way more.

    1. Taylor Gauss

      Hi Yusuf! So for your first question, we had interns introduce themselves to patients in the waiting room, so the participants weren’t in any course and they agreed to be shadowed at that time! As for hand hygiene, we based it on UF’’s protocol, which is to gel in and out after every room. While their hands may be clean, they’re still not following protocol.

    1. Taylor Gauss

      Hi Peggy! So I am unfamiliar with the process of having scribes in a doctors appointment, so I’m not sure if scribes are allowed to communicate with patients. I don’t think it would necessarily increase empathy because it isn’t necessarily the provider changing his/her empathy skills, but if the scribe was there and the scribe may help the doctor not face the computer, then I believe it would!

  2. Maddie Rodriguez

    Hello! This study is fantastic! You guys did an amazing job! I think that empathy is a big thing to improve on and can make a huge difference!

  3. Elisabeth Osorio

    Hi Taylor,
    Thank you for sharing your research. You and your team has done a great job.
    I have a handful of questions for you:
    What were the methods for determining room cleanliness?
    What differences between the Fixel Institute, Neuromedicine Clinic, and Neurology Medical Plaza do you believe may account for the discrepancies you found in patient care standards? Are patient populations different, are staff trainings/culture different, is the nature of the clinical practice different and how so?

    1. Taylor Gauss

      Hi Elisabeth! So for room cleanliness, we had an evaluation sheet for every patient shadower to limit variability. This included trash (I.e. paper towels on the floor), dirtiness, and smell! As for differences, all UF Health staff receive the same training despite locations, but what they specialize is different. For example, Fixel is specifically on movement disorders while the Neuromedicine clinics may focus on other neurological issues such as muscular dystrophy, epilepsy, or seizures. So the patient population is different, as well as the setting. The neuromedicine clinic is in an actual hospital, while medical plaza and Fixel institute are simply clinical buildings. This could account for some discrepancies. Wonderful questions!

  4. Anays Hernandez

    Hi Taylor! How do you believe that the face-to-face contact between patients and clinical workers can be brought back to clinics/hospitals in an era where almost everything is based on technology?

    1. Taylor Gauss

      Hi Anays! Unfortunately, that is where healthcare settings are heading to, but I feel practices should be put in place for fellows and medical students that they should not forget about the patient. They could practice listening to the patient and their experience first, and then input their data in after (to increase empathy).

  5. Daphne Bricker

    Great project! How do you think your results would change if you focused specifically on patient satisfaction (such as patient ratings of their level of satisfaction? Thank you!