Measuring the quality of patient-centered care: why patient-reported measures are critical to reliable assessment

Abstract

PurposeThe Institute of Medicine (IOM) identified patient-centeredness as crucial to quality health care. The IOM endorsed six patient-centeredness dimensions that stipulated that care must be: respectful to patients’ values, preferences, and expressed needs; coordinated and integrated; provide information, communication, and education; ensure physical comfort; provide emotional support; and involve family and friends. Patient-reported measures examine the patient’s perspective and are essential to the accurate assessment of patient-centered care. This article’s objectives are to: 1) use the six IOM-endorsed patient-centeredness dimensions as a framework to outline why patient-reported measures are crucial to the reliable measurement of patient-centered care; and 2) to identify existing patient-reported measures that assess each patient-centered care dimension.MethodsFor each IOM-endorsed patient-centeredness dimension, the published literature was searched to highlight the essential role of patients in assessing patient-centered care and informing quality improvement efforts. Existing literature was also searched to identify examples of patient-reported measures that assess each patient-centeredness dimension.ConclusionPatient-reported measures are arguably the best way to measure patient-centeredness. For instance, patients are best positioned to determine whether care aligns with patient values, preferences, and needs and the Measure of Patient Preferences is an example of a patient-reported measure that does so. Furthermore, only the patient knows whether they received the level of information desired, and if information was understood and can be recalled. Patient-reported measures that examine information provision include the Lung Information Needs Questionnaire and the EORTC QLQ-INFO25. In relation to physical comfort, only patients can report the severity of physical symptoms and whether medications provide adequate relief. Patient-reported measures that investigate physical comfort include the Pain Care Quality Survey and the Brief Pain Inventory. Using patient-reported measures to regularly measure patient-centered care is critical to identifying areas of health care where improvements are needed.

Patient‐ and family‐centred care in the intensive care unit: a challenge in the daily practice of healthcare professionals

“…Relatives themselves are most knowledgeable about whether organisational policies aligns with their needs (Arcrcitvij , Tzelepis et al . ). As an example, the CQI ‘R‐ICU’ is an instrument to express the relatives’ values and assess their experiences in the quality of care.…”

“…Subsequently, PFCC needs to respect, value and understand how patients may perceive the different aspects of quality of care improvements (Renedo & Marston , Tzelepis et al . ). These patient‐reported measures are essential to quality improvement programmes as they will provide feedback regarding patient‐centredness in daily practice to healthcare professionals and policymakers.…”

“…The Institute of Medicine (IOM) recognises six patient‐centredness aspects in defining qualitatively good health care: (1) it is respectful to patients’ values, preferences and expressed needs; (2) it is coordinated and integrated; (3) it provides information, communication and education; (4) it ensures physical comfort; (5) it provides emotional support; and (6) it involves family and friends (Arcrcitvij , Tzelepis et al . ). This IOM patient‐centred framework provides the theoretical background in caring of this article.…”

Quality of care: measuring a neglected driver of improved health

“…Face-to-face interviews with patients, and written surveys, are typically used to measure the patient experience. Patients are best-positioned to determine whether care aligns with their values and preferences, and to convey their experience of provider communication, service convenience and so on 47 . The expansion of communication technology and social media provides new opportunities for getting feedback on quality of care and returning relevant information back to users.…”

Patients’ experiences and preferences for opt‐in models and health professional involvement in biobanking consent: A cross‐sectional survey of Australian cancer outpatients

“…Placing patients at the forefront of the consent process, including consideration of their preferences for recruitment approaches, aligns closely with the ethos of patient‐centered care. Patient‐centered care is one of the key components to high‐quality healthcare endorsed by the Institute of Medicine, World Health Organization, The Commonwealth Fund, and the Organisation for Economic Co‐operation and Development and emphasizes individuals’ right to participate in treatment decisions as informed and valued partners in the therapeutic alliance . This right should be extended to research participation such that all eligible individuals be made aware of their opportunities to be involved in research in an equitable manner regardless of demographic characteristics.…”