Abstract
ObjectiveThe objective of this study was to describe the involvement of patients or their representatives in quality management (QM) functions and to assess associations between levels of involvement and the implementation of patient-centred care strategies.DesignA cross-sectional, multilevel study design that surveyed quality managers and department heads and data from an organizational audit.SettingRandomly selected hospitals (n = 74) from seven European countries (The Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey).ParticipantsHospital quality managers (n = 74) and heads of clinical departments (n = 262) in charge of four patient pathways (acute myocardial infarction, stroke, hip fracture and deliveries) participated in the data collection between May 2011 and February 2012.Main Outcome MeasuresFour items reflecting essential patient-centred care strategies based on an on-site hospital visit: (1) formal survey seeking views of patients and carers, (2) written policies on patients' rights, (3) patient information literature including guidelines and (4) fact sheets for post-discharge care. The main predictors were patient involvement in QM at the (i) hospital level and (ii) pathway level.ResultsCurrent levels of involving patients and their representatives in QM functions in European hospitals are low at hospital level (mean score 1.6 on a scale of 0 to 5, SD 0.7), but even lower at departmental level (mean 0.6, SD 0.7). We did not detect associations between levels of involving patients and their representatives in QM functions and the implementation of patient-centred care strategies; however, the smallest hospitals were more likely to have implemented patient-centred care strategies.ConclusionsThere is insufficient evidence that involving patients and their representatives in QM leads to establishing or implementing strategies and procedures that facilitate patient-centred care; however, lack of evidence should not be interpreted as evidence of no effect.
Highlights
MethodsThe role of involving patients in designing and assessing health care services has increased substantially over the last few years [1]
Current levels of involving patients and their representatives in quality management (QM) functions in European hospitals are low at hospital level, but even lower at departmental level
There is insufficient evidence that involving patients and their representatives in QM leads to establishing or implementing strategies and procedures that facilitate patient-centred care; lack of evidence should not be interpreted as evidence of no effect
Summary
MethodsThe role of involving patients in designing and assessing health care services has increased substantially over the last few years [1]. The involvement of patients and their representatives in health care takes many forms, ranging from lay membership in managerial boards to involvement in condition-specific activities, such as services design, development of patient information material, identification of improvement priorities, or assessing and interpreting results of patient surveys. Hospitals recognized for their leadership in the field of patient-centred care involve patients or patient representatives in formal quality functions (such as setting standards or targets, and discussing results)
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