Positive and negative experiences and emotions of older patients before, during and after hospital admission: patient journey mapping

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. Therefore, our study aims to explore older patient’s needs, wishes, and experiences by applying a patient journey mapping approach for older patients to enhance PCC. 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 and post-discharge follow-ups were conducted with patients aged ≥ 70 from multiple Dutch hospital departments from April to December 2024. Interview notes were summarized, compiled and organized using a patient journey map template. Data were analysed inductively through thematic content analysis, supported by MAXQDA V9 for open coding, to identify care phases, stakeholders, experiences, emotions, and needs. Patient Journey Maps (PJMs) were iteratively refined with the research team. COREQ guidelines were followed for reporting. A total of 132 patients (48% female, 52% male) participated, with a mean age of 79 years. Participants were recruited from six hospitals, with most (68%) undergoing an acute non-surgical care journey. Follow-up was completed by 59%. PJMs, categorized into four quadrants (acute surgical (14%), acute non-surgical (68%), non-acute surgical (12%), non-acute non-surgical (6%)), offered a comprehensive view of variable patient experiences, interactions, emotions and (unmet) needs. 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. These findings offer insights to improve patient experiences and support more person-centered care for an aging population.