Measurement of the Patient Experience: Clarifying Facts, Myths, and Approaches

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a 32-item tool administered after discharge to a random sample of adult inpatients, creating standardized, publicly reported metrics that allow fair comparisons of patient experience in hospitals across the nation.

The 11 HCAHPS measures derived from the survey reported on the Hospital Compare website assess how well nurses and physicians communicate with patients, how responsive hospital staff are to patients’ needs, how well hospital staff help patients manage pain, how well the staff communicates with patients about new medicines, whether key information is provided at discharge, how smoothly the transition to the posthospital setting is made, how clean and quiet are the patients’ rooms, what is the hospital’s overall rating, and whether the patient would recommend the hospital.

HCAHPS resides in the public domain and accommodates customized supplemental items that are not reviewed or endorsed by the ...

Evolving Concepts of Patient-Centered Care and the Assessment of Patient Care Experiences: Optimism and Opposition

This article summarise, a personal view of the author (Paul D. Cleary dean of the Yale School of Public Health), on the available research, concerning measurement of “patient satisfaction” and “patient care experience”. Author argues that patient experiences measurement efforts are being devoted to providing high-quality patient-centered care. Some indicators and surveys are discussed in terms of their reliability, validity and correlation across individuals and settings with other quality indicators.

Special attention is paid to the Consumer Assessment of Healthcare Providers and Systems (CAHPS), launched in 1995 by the Agency for Healthcare Research and Quality (AHRQ). The CAHPS surveys are nowadays tailored to different care settings, so that results can be used to help identify aspects of care that can be targeted to improve patient experiences.

Some contrasting arguments are also discussed on the ability of patients to evaluate the quality of their care. Author proposes a review of currently ...

Instruments Measuring Integrated Care: A Systematic Review of Measurement Properties

Integrated care is an important strategy for increasing health system performance. Despite ots growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague and limited. This systematic review aims to provide evidence on the state of the art in measuring integrated care. 

Government leadership that supports community-lead integrated care: An analysis of advances and missteps

Integrated care that substantively impacts population health as well as provides quality care requires buy-in, engagement and commitment over time by a plethora of  government and community groups. There is considerable evidence of the complexity of care models that work such that long term commitment is required to truly impact health. These days, beyond work opportunities, most municipal government and community leaders realise that good quality health services are critical to retaining and recruiting residents, especially noteworthy as an issue in rural communities.  How do places manage bottom-up, top-down tensions as politics and control issues intervene across differrent levels of government? What sort of governmental leadership inspires community engagement versus chronic frustration?

Measuring the benefits of the integration of health and social care: qualitative interviews with professional stakeholders and patient representatives

Integrated care has the potential to ease the increasing pressures faced by health and social care systems, however, challenges around measuring the benefits for providers, patients, and service users remain. This paper explores stakeholders’ views on the benefits of integrated care and approaches to measuring the integration of health and social care.

Development of the person-centered prenatal care scale for people of color

Given the stark disparities in maternal mortality and adverse birth outcomes among Black, indigenous, and other people of color, there is a need to better understand and measure how individuals from these communities experience their care during pregnancy. This study aimed to develop and validate a tool that can be used to measure person-centered prenatal care that reflects the experiences of people of color. It prsents 2 versions of the person-centered prenatal care scale. Both versions have high validity and reliability in a sample made up predominantly of Black women. This scale will facilitate measurement to improve person-centered prenatal care for people of color and could contribute to reducing disparities in birth outcomes.

Person-centred care and measurement: The more one sees, the better one knows where to look

Determining the quality of a health system is a complex and challenging endeavour. The variety of perspectives needed to determine quality means that increasingly complex measurement frameworks are often employed. Providing the best possible health care has always been a priority for health system leaders, individual professions and individual professionals. But the importance and significance of measuring quality has increased since the evolution of quality-improvement methodologies for health-care quality standardisation in the 1990s.

Audit and feedback systems evolved into quality-control methods with the increased industrialisation of health systems. As the patient voice became increasingly important, with the rise in advocacy groups and patient-representative organisations, the focus on controlling the quality of services through a managerialist ideology was challenged. Broader, more inclusive, approaches to quality were embraced. Quality-improvement methodologies aim to adopt an inclusive approach to ongoing quality enhancement, ensuring that services are continuously developed and improved. This evolutionary context is ...

Person-centred sexual and reproductive health: A call for standardized measurement

Person-centred sexual and reproductive health (PCSRH) care refers to care that is respectful of and responsive to people's preferences, needs, and values, and which empowers them to take charge of their own sexual and reproductive health (SRH). It is an important indicator of SRH rights and quality of care. Despite the recognition of the importance of PCSRH, there is a gap in standardized measurement in some SRH services, as well as a lack of guidance on how similar person-centred care measures could be applied across the SRH continuum. Drawing on validated scales for measuring person-centred family planning, abortion, prenatal and intrapartum care, we propose a set of items that could be validated in future studies to measure PCSRH in a standardized way. A standardized approach to measurement will help highlight gaps across services and facilitate efforts to improve person-centred care across the SRH continuum.