Quality improvement and person-centredness: a participatory mixed methods study to develop the 'always event' concept for primary care

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Author(s)
Bowie, Paul
McNab, Duncan
Ferguson, Julie
de Wet, Carl
Smith, Gregor
MacLeod, Marion
McKay, John
White, Craig
Griffith University Author(s)
Year published
2015
Metadata
Show full item recordAbstract
Objectives: (1) To ascertain from patients what really
matters to them on a personal level of such high
importance that it should ‘always happen’ when they
interact with healthcare professionals and staff groups.
(2) To critically review existing criteria for selecting
‘always events’ (AEs) and generate a candidate list of
AE examples based on the patient feedback data.
Design: Mixed methods study informed by
participatory design principles.
Subjects and setting: Convenience samples of
patients with a long-term clinical condition in Scottish
general practices.
Results: 195 patients from 13 general practices were
interviewed ...
View more >Objectives: (1) To ascertain from patients what really matters to them on a personal level of such high importance that it should ‘always happen’ when they interact with healthcare professionals and staff groups. (2) To critically review existing criteria for selecting ‘always events’ (AEs) and generate a candidate list of AE examples based on the patient feedback data. Design: Mixed methods study informed by participatory design principles. Subjects and setting: Convenience samples of patients with a long-term clinical condition in Scottish general practices. Results: 195 patients from 13 general practices were interviewed (n=65) or completed questionnaires (n=130). 4 themes of high importance to patients were identified from which examples of potential ‘AEs’ (n=8) were generated: (1) emotional support, respect and kindness (eg, “I want all practice team members to show genuine concern for me at all times”); (2) clinical care management (eg, “I want the correct treatment for my problem”); (3) communication and information (eg, “I want the clinician who sees me to know my medical history”) and (4) access to, and continuity of, healthcare (eg, “I want to arrange appointments around my family and work commitments”). Each ‘AE’ was linked to a system process or professional behaviour that could be measured to facilitate improvements in the quality of patient care. Conclusions: This study is the first known attempt to develop the AE concept as a person-centred approach to quality improvement in primary care. Practice managers were able to collect data from patients on what they ‘always want’ in terms of expectations related to care quality from which a list of AE examples was generated that could potentially be used as patientdriven quality improvement (QI) measures. There is strong implementation potential in the Scottish health service. However, further evaluation of the utility of the method is also necessary.
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View more >Objectives: (1) To ascertain from patients what really matters to them on a personal level of such high importance that it should ‘always happen’ when they interact with healthcare professionals and staff groups. (2) To critically review existing criteria for selecting ‘always events’ (AEs) and generate a candidate list of AE examples based on the patient feedback data. Design: Mixed methods study informed by participatory design principles. Subjects and setting: Convenience samples of patients with a long-term clinical condition in Scottish general practices. Results: 195 patients from 13 general practices were interviewed (n=65) or completed questionnaires (n=130). 4 themes of high importance to patients were identified from which examples of potential ‘AEs’ (n=8) were generated: (1) emotional support, respect and kindness (eg, “I want all practice team members to show genuine concern for me at all times”); (2) clinical care management (eg, “I want the correct treatment for my problem”); (3) communication and information (eg, “I want the clinician who sees me to know my medical history”) and (4) access to, and continuity of, healthcare (eg, “I want to arrange appointments around my family and work commitments”). Each ‘AE’ was linked to a system process or professional behaviour that could be measured to facilitate improvements in the quality of patient care. Conclusions: This study is the first known attempt to develop the AE concept as a person-centred approach to quality improvement in primary care. Practice managers were able to collect data from patients on what they ‘always want’ in terms of expectations related to care quality from which a list of AE examples was generated that could potentially be used as patientdriven quality improvement (QI) measures. There is strong implementation potential in the Scottish health service. However, further evaluation of the utility of the method is also necessary.
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Journal Title
BMJ Open
Volume
5
Issue
4
Copyright Statement
© 2015 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Subject
Medical and Health Sciences not elsewhere classified
Clinical Sciences
Public Health and Health Services
Other Medical and Health Sciences