Article Text
Abstract
Rationale There is an increasing societal demand for quality assurance and transparency of medical care. The American National Academy of Medicine has determined patient centredness as a quality domain for improvement of healthcare. While many of the current quality indicators are disease specific, most emergency department (ED) patients present with undifferentiated complaints. Therefore, there is a need for generic outcome measures. Our objective was to determine relevant patient reported outcomes (PROs) for quality measurement of acute care.
Methods We conducted semistructured interviews in patients ≥18 years presenting at the ED for internal medicine. Patients with a cognitive impairment or language barrier were excluded. Interviews were analysed using qualitative content analysis.
Results Thirty patients were interviewed. Patients reported outcomes as relevant in five domains: relief of symptoms, understanding the diagnosis, presence and understanding of the diagnostic and/or therapeutic plan, reassurance and patient experiences. Experiences were often mentioned as relevant to the perceived quality of care and appeared to influence the domain reassurance.
Conclusion We determined five domains of relevant PROs in acute care. These domains will be used for developing generic patient reported measures for acute care. The patients’ perspective will be incorporated in these measures with the ultimate aim of organising truly patient-centred care at the ED.
- healthcare quality improvement
- patient-centred care
- patient reported outcome measures
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Footnotes
Contributors FH conceived the idea for this research. MNTK, HRH and PWBN designed the project. TZ, MNTK and ESvdE were responsible for inclusion of participating patients. MNTK, ESvdE and MvB executed the interviews and focus groups. TZ and MNTK transcribed and coded all interviews and focus groups. MNTK and TZ drafted the manuscript. All authors (MNTK, TZ, ESvdE, MvB, FH, PWBN and HRH) critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.
Funding The Dutch Society for internists (Nederlandse Internisten Vereniging) provided funding for this research.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study protocol was approved by the Medical Ethics Committees of the participating hospitals (Máxima Medical Centre, Amsterdam UMC location VUmc and AMC).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.