Patient's perspective on improving the quality of acute medical care: determining patient reported outcomes.

Autor:	Kremers MNT; Faculty of Health Medicine and Life Sciences, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care, Maastricht University, Maastricht, The Netherlands.; Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands., Zaalberg T; Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands., van den Ende ES; Internal Medicine, Section Acute Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands., van Beneden M; Internal Medicine, Section Acute Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands., Holleman F; Internal Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Nanayakkara PWB; Internal Medicine, Section Acute Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands., Haak HR; Faculty of Health Medicine and Life Sciences, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care, Maastricht University, Maastricht, The Netherlands.; Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2019 Sep 29; Vol. 8 (3), pp. e000736. Date of Electronic Publication: 2019 Sep 29 (Print Publication: 2019).
DOI:	10.1136/bmjoq-2019-000736
Abstrakt:	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. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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