Measuring patient-centred system performance: a scoping review of patient-centred care quality indicators

Abstract

ObjectivesThe shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality indicators that can be used to measure PCC.MethodsDesign: scoping review. Data Sources: studies were identified through searching seven electronic databases and the grey literature. Search terms included quality improvement, quality indicators, healthcare quality and PCC. Eligibility Criteria: articles were included if they mentioned development and/or implementation of PC-QIs. Data Extraction and Synthesis: extracted data included study characteristics (country, year of publication and type of study/article), patients’ inclusion in the development of indicators and type of patient populations and point of care if applicable (eg, in-patient, out-patient and primary care).ResultsA total 184 full-text peer-reviewed articles were assessed for eligibility for inclusion; of these, 9 articles were included in this review. From the non–peer-reviewed literature, eight documents met the criteria for inclusion in this study. This review revealed the heterogeneity describing and defining the nature of PC-QIs. Most PC-QIs were presented as PCC measures and identified as guidelines, surveys or recommendations, and therefore cannot be classified as actual PC-QIs. Out of 502 ways to measure PCC, only 25 were considered to be actual PC-QIs. None of the identified articles implemented the quality indicators in care settings.ConclusionThe identification of PC-QIs is a key first step in laying the groundwork to develop evidence-based PC-QIs. Research is needed to continue the development and implementation of PC-QIs for healthcare quality improvement.

How do they measure up? Differences in stakeholder perceptions of quality measures used in English community nursing

“…Responsiveness was characterized in our findings as relating to ‘softer’ aspects of care, highly valued by both frontline staff and service users. It is known that the priorities of service users and of healthcare providers are not necessarily aligned 6 ; however, in an age when delivering ‘patient-centred care’ is the stated aim of English and many other healthcare services, 28,29 it is ironic that none of the systems in place for measuring community nursing care appear to have been designed with service user priorities in mind. Despite ongoing debates concerning the definition of ‘patient-centred care’, 29 it is arguably the case that there should at least be provision for the patient voice to contribute to the identification and selection of measures designed to assess care quality.…”

“…These problems are not limited to England. Internationally, the drive to develop community-based collaborative care continues 27 along with an acknowledged need to develop suitable patient-centred care assessment processes 4,6,29 and nursing-sensitive indicators for community-based nursing care. 17,20 Additionally, it is known that applying unsuitable indicators can result in unintended consequences with concomitant problems for staff and service users.…”

Improving the quality of person-centred healthcare from the patient perspective: development of person-centred quality indicators

“…In parallel to the scoping review, 19 an environmental scan was conducted to identify whether healthcare systems in Canada, the UK, Sweden, Australia and New Zealand were using PC-QIs, which PC-QIs were in use, and how they were implemented. 20 These countries were chosen as they shared many similarities with respect to healthcare delivery and structures.…”

Eliciting preferences for outpatient care experiences in Hungary: A discrete choice experiment with a national representative sample

“…In the last decade, we have observed a growing interest on patient-reported experience measures (PREMs). These measures became a widely used quality indicator to inform the general public, policy-makers, but also health care professionals and organizations about patient-centered health care service delivery, wherein aspects of the care experience are measured [4,5]. However, a shortcoming to most instruments on PREMs should be acknowledged: many lack standardization or proper reporting about its validity/reliability [4].…”