Determinants of patient loyalty to healthcare providers: An integrative review.

PURPOSE: Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. DATA SOURCES: PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. STUDY SELECTION: Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. DATA EXTRACTION: Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. RESULTS OF DATA SYNTHESIS: Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. CONCLUSION: This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty.

Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review.

Effective communication among healthcare professionals in the intensive care unit (ICU) is a particular imperative, with accurate and efficient interdisciplinary communication being a critical prerequisite for high-quality care. Nurses and physicians are highly important parts of the healthcare system workforce. Thus, identifying strategies that would improve communication between these two groups can provide evidence for practical improvement in the ICU, which will ultimately improve patient outcomes. This integrative literature review aimed to identify interventions that improve communication between nurses and physicians in ICUs. Three databases (Medline, CINAHL, and Science Direct) were searched between September 2014 and June 2016 using 11 search terms, namely, nurse, doctor, physician, resident, clinician, ICU, intensive care unit, communication, teamwork, collaboration, and relationship. A manual search of the reference lists of found papers was also conducted. Eleven articles met the inclusion criteria. These studies reported on the use of communication tools/checklists, team training, multidisciplinary structured work shift evaluation, and electronic situation-background-assessment-recommendation documentation templates to improve communication. Although which intervention strategies are most effective remains unclear, this review suggests that these strategies improve communication to some extent. Future studies should be rigorously designed and outcome measures should be specific and validated to capture and reflect the effects of effective communication.