Experiences of older patients before, during and after hospital admission: Patient Journey Mapping

Background: The aging population presents a growing challenge for healthcare systems, with older adults, particularly those aged 70 and older, accounting for a significant proportion of hospital admissions due to chronic conditions and multimorbidity. Older patients often require coordinated care across multiple providers, making their healthcare trajectories complex and critical. Enhancing patient-centered care (PCC) is essential for improving outcomes and aligning healthcare with patients' needs and preferences. Methods This qualitative study employed a patient journey mapping approach to explore patients' experiences, needs, and wishes before, during, and after hospital admission. Semi-structured interviews during hospital admission and follow-up conversations after hospital discharge were conducted with admitted patients aged ≥ 70 across multiple Dutch hospital departments from April to December 2024. During the interviews and follow-up conversations, notes were summarized, compiled, and organized using a patient journey map template. Data were analysed using an inductive thematic content analysis, supported by MAXQDA V9 for open coding, focussing on identifying care phases of the patient journey, involved stakeholders, positive and negative experiences, emotions, and needs. The patient journey maps were iteratively developed in collaboration with the research team. The COREQ guidelines were followed for reporting. Results: A total of 132 patients (48% female, 52% male) participated, with a mean age of 79 years. Participants were recruited from six hospitals, with 68% undergoing an acute non-surgical journey. Follow-up was completed by 59%. Patient journey maps, categorized into four quadrants (acute surgical, acute non-surgical, non-acute surgical, non-acute non-surgical), offered a comprehensive view of patient experiences highlighting a variability of interactions, emotions, and needs. Conclusion: Patient journey mapping captured a diversity of experiences of a large cohort of older adults (≥ 70 years) before, during and after hospitalization, revealing critical areas for improvement. Key opportunities for improvement included expectation management, compassionate care, clear information handover, and coordinated general practitioner follow-up, offering insights to improve patient experiences and support more person-centered care for an aging population.