Patient journey mapping in people with complex wounds: Experience and perceived quality

Chronic and complex wounds involve prolonged care processes that may affect patient experience and perceived quality of care. This study aimed to map the patient journey of people living with chronic or complex wounds using a journey map and to identify critical points and levels of satisfaction with the healthcare services used.

We conducted a mixed-methods qualitative-quantitative study. Semi-structured interviews were held with patients aged ≥18 years with at least one complex wound, under treatment and follow-up in specialised wound care units within Osakidetza between May and October 2025, using purposive sampling to maximise heterogeneity. Participants' narratives were used to develop a journey map of the care process, and satisfaction at each level of care was assessed with two questions based on the Net Promoter Score (NPS).

Theoretical saturation was reached after 36 interviews. Seven stages along the care journey were identified (from wound onset to changes in routines and loss of autonomy), with critical points related to initial uncertainty, perceived minimisation of the problem at first contact, discontinuity of professionals and delays in referral. NPS indices were lower in primary care centres (13 and 16) and higher in specialised units (83 and 92), indicating greater satisfaction with care in the latter.

Mapping the patient journey of people with chronic or complex wounds allows potentially modifiable stages and critical points to be identified, as well as differences in satisfaction between levels of care. These findings may help to guide interventions aimed at improving cross-level coordination, clarifying referral criteria and strengthening the problem-solving capacity of primary care, thereby supporting a more satisfactory care experience.