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. 2020 Oct 29;10(10):e037323.
doi: 10.1136/bmjopen-2020-037323.

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

Maria-Jose Santana  1   2 , Kimberly Manalili  3 , Sandra Zelinsky  2   4 , Susan Brien  5 , Elizabeth Gibbons  6 , Jenny King  7 , Lori Frank  8 , Sara Wallström  9   10 , Paul Fairie  3 , Kira Leeb  11 , Hude Quan  3 , Richard Sawatzky  12
Affiliations

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

Maria-Jose Santana et al. BMJ Open. .

Abstract

Importance: International efforts are being made towards a person-centred care (PCC) model, but there are currently no standardised mechanisms to measure and monitor PCC at a healthcare system level. The use of metrics to measure PCC can help to drive the changes needed to improve the quality of healthcare that is person centred.

Objective: To develop and validate person-centred care quality indicators (PC-QIs) measuring PCC at a healthcare system level through a synthesis of the evidence and a person-centred consensus approach to ensure the PC-QIs reflect what matters most to people in their care.

Methods: Existing indicators were first identified through a scoping review of the literature and an international environmental scan. Focus group discussions with diverse patients and caregivers and interviews with clinicians and experts in quality improvement allowed us to identify gaps in current measurement of PCC and inform the development of new PC-QIs. A set of identified and newly developed PC-QIs were subsequently refined by Delphi consensus process using a modified RAND/UCLA Appropriateness Method. The international consensus panel consisted of patients, family members, community representatives, clinicians, researchers and healthcare quality experts.

Results: From an initial 39 unique evidence-based PC-QIs identified and developed, the consensus process yielded 26 final PC-QIs. These included 7 related to structure, 16 related to process, 2 related to outcome and 1 overall global PC-QI.

Conclusions: The final 26 evidence-based and person-informed PC-QIs can be used to measure and evaluate quality incorporating patient perspectives, empowering jurisdictions to monitor healthcare system performance and evaluate policy and practice related to PCC.

Keywords: health policy; organisation of health services; quality in health care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
An overview of the programme of research on developing person-centred quality indicators (PC-QIs). The programme of research includes three phases of research: identifying and developing PC-QIs; refinement of the PC-QIs and feasibility of assessment of the newly developed PC-QIs. This manuscript shows the final results (final set PC-QIs), based on research from the first two phases.
Figure 2
Figure 2
Shows a flow chart of the PC-QI Delphi process, describing the timeline for rounds alongside the numbers of PC-QIs surviving each round. There are arrows pointing down from ‘39 PCQIs evaluated’ to each subsequent ‘n PCQIs evaluated’ box, until the final ‘26 PCQIs evaluated’ box. PC-QIs, person-centred care quality indicators.
See this image and copyright information in PMC

References

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