{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:30:58Z","timestamp":1787070658080,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Learning Health Systems (LHS) offer a pathway to continuously improve care by integrating data and lived experience, yet few practical examples demonstrate how LHS can be operationalized in hospital settings in ways that embed the voices of patients and families. This manuscript describes how patient experience (PX) data are integrated into the design of a new model of care (MoC) that responds to both system demands and the realities of patients and families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Researchers partnered with clinical leaders to integrate patient and family voices into the design of a new MoC using PX survey data, interviews with patients and families admitted to medicine units, and naturalistic walk\u2010throughs of each medicine unit. Data collection explored care priorities, interactions with staff, physical environments, and reflections on positive and challenging aspects of care. Analysis followed a three\u2010step iterative process: unit\u2010level synthesis, cross\u2010unit thematic comparison, and data integration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 390 patients participated in the PX survey and 19 patients\/families participated in interviews. Patients situated their experiences within a health care system under strain, highlighting both strengths and gaps. Many expressed appreciation for nurses' compassion, but emotional support for fears, anxieties, and worries was inconsistent, particularly when staff were overstretched or transient. Long wait times for transport, procedures, or basic care needs were reported as sources of anxiety and diminished dignity. Naturalistic walk\u2010throughs documented how crowding, noise, lighting, and wayfinding shaped patients' comfort and privacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This work provides a practical example of how an LHS approach can be operationalized by embedding the voices of patients and families into care redesign. Findings from the PX survey and interviews are directly shaping a new MoC at Trillium Health Partners (THP) that is evidence\u2010informed and co\u2010designed with patients and families, providing a practical example of how PX data can drive continuous, system\u2010level learning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70113","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:59:47Z","timestamp":1786985987000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Operationalizing Patient Experience Data as a System Feedback Asset in Learning Health Systems: Learnings From Model of Care Redesign at Trillium Health Partners"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4581-7714","authenticated-orcid":false,"given":"Umair","family":"Majid","sequence":"first","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1988-8383","authenticated-orcid":false,"given":"Arija","family":"Birze","sequence":"additional","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7792-8099","authenticated-orcid":false,"given":"Danielle","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5214-7974","authenticated-orcid":false,"given":"Michelle","family":"Marcinow","sequence":"additional","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Murray","sequence":"additional","affiliation":[{"name":"Model of Care, Trillium Health Partners  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanyue","family":"Chen","sequence":"additional","affiliation":[{"name":"Model of Care, Trillium Health Partners  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2188-0767","authenticated-orcid":false,"given":"Marissa","family":"Bird","sequence":"additional","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Gdyczynski","sequence":"additional","affiliation":[{"name":"Patient Experience Measurement and Planning, Trillium Health Partners  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6377-6653","authenticated-orcid":false,"given":"Kerry","family":"Kuluski","sequence":"additional","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Balancing the Needs of Canadians and Our Health Workforce","author":"Canadian Institute for Health Information","year":"2024"},{"key":"e_1_2_9_3_1","volume-title":"Canada's Health System Is Experiencing an Unprecedented Health Workforce Crisis","author":"Government of Canada","year":"2023"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/08404704231183863"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/19375867221137097"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-023-00465-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lrh2.10265"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.15265\/IY-2017-004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.35680\/2372-0247.1439"},{"key":"e_1_2_9_10_1","volume-title":"The Learning Health System (LHS) Action Framework","author":"Reid R. J.","year":"2023"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lrh2.10258"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.35680\/2372-0247.1656"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmhs.2025.100091"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.17645\/up.v3i4.1700"},{"key":"e_1_2_9_15_1","volume-title":"Patient Experience Measurement: Recommended Patient Experience Surveys","author":"Ontario Hospital Association","year":"2026"},{"issue":"21","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","DOI":"10.1177\/16094069221107144","article-title":"Methodological Insights From a Virtual, Team\u2010Based Rapid Qualitative Method Applied to a Study of Providers' Perspectives of the COVID\u201019 Pandemic Impact on Hospital\u2010To\u2010Home Transitions","volume":"2","author":"Singh H.","year":"2022","journal-title":"International Journal of Qualitative Methods"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732320921835"},{"key":"e_1_2_9_18_1","unstructured":"Otter.ai Inc Otter.ai (Version) [Computer Sftware](2025)https:\/\/otter.ai\/."},{"key":"e_1_2_9_19_1","unstructured":"M.Morrison \u201cHistory of the SWOT Analysis (Brief) [Originally SOFT Analysis] \u201d (2012)https:\/\/rapidbi.com\/history\u2010of\u2010the\u2010swot\u2010analysis\/."},{"key":"e_1_2_9_20_1","volume-title":"Census Profile, 2021 Census of Population: Mississauga, City (CY), Ontario","author":"Statistics Canada","year":"2022"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3597-2"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-4901-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/NNA.0000000000000101"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11143976"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40886-018-0073-1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-023-04495-8"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10358-1"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.12332"},{"key":"e_1_2_9_29_1","volume-title":"Industrial Dynamics","author":"Forrester J. W.","year":"1961"},{"key":"e_1_2_9_30_1","volume-title":"The Fifth Discipline: The Art and Practice of the Learning Organization","author":"Senge P. M.","year":"1990"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czae113"},{"key":"e_1_2_9_32_1","volume-title":"Systems Thinking for Social Change: A Practical Guide to Solving Complex Problems, Avoiding Unintended Consequences, and Achieving Lasting Results","author":"Stroh D. P.","year":"2015"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4505-12-51"},{"key":"e_1_2_9_34_1","volume-title":"Advances in Patient Safety: New Directions and Alternative Approaches (Vol 2: Culture and Redesign)","author":"Johnson J. K.","year":"2008"},{"key":"e_1_2_9_35_1","volume-title":"Systems Thinking in the Healthcare Professions: A Guide for Educators and Clinicians","author":"Kim D. H.","year":"2018"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009002"},{"key":"e_1_2_9_37_1","volume-title":"Bringing User Experience to Healthcare Improvement: The Concepts, Methods and Practices of Experience\u2010Based Design","author":"Bate P.","year":"2007"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.2752\/175630615X14212498964312"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.1133"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12197"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/frhs.2025.1606124"}],"container-title":["Learning Health Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.70113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lrh2.70113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.70113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:34:19Z","timestamp":1787067259000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lrh2.70113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/lrh2.70113"],"URL":"https:\/\/doi.org\/10.1002\/lrh2.70113","archive":["Portico"],"relation":{},"ISSN":["2379-6146","2379-6146"],"issn-type":[{"value":"2379-6146","type":"print"},{"value":"2379-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"assertion":[{"value":"2026-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70113"}}