Hospital performance, from the patient’s perspective

A UNC Lineberger Comprehensive Cancer Center researcher led a panel of experts to develop recommendations for how to best develop patient-focused assessments of health care performance. They published their findings in an article in the journal Value in Health.

Patients care about how well pain, nausea, or treatment side effects are managed when evaluating the quality of the medical care they receive, but information about these experiences is not generally collected. To incorporate the values that patients care most about into formal assessments of provider and health system performance, a UNC Lineberger Comprehensive Cancer Center researcher led an expert panel to create a playbook on how to best develop, analyze and use patient-focused measures.

This work is needed, said Ethan Basch, MD, MSc, director of the Cancer Outcomes Research Program at UNC Lineberger, because patient-reported feedback about symptoms and functioning is rarely used to measure quality of care. Performance is typically measured based on hospital readmission rates, infections, procedural complications, or survival, Basch and his collaborators reported in a new article in the journal Value in Health.

“It’s important to understand how patients feel in the assessment of quality of medical care, and there are established methods for gathering that information,” said Basch, who is an associate professor in the UNC School of Medicine, and the paper’s lead author.

Basch led a panel of experts from the American Medical Association’s Physician Consortium for Performance Improvement to develop the playbook of best practices for implementing patient-centered assessments of health care quality. 

The group reviewed practices already implemented as well as existing studies on the subject to come up with nine recommendations for developing, using and interpreting the results of patient questionnaires on quality.

Basch said a key recommendation that came out of the group’s work is that it’s important to measure performance based on what’s important to patients. The only way to determine what is important to patients is to systematically ask the patients themselves.

The hope is that their work will encourage more integration of patient-reported outcomes into performance assessment efforts.

“There are now established methods for developing these measures, and the challenge ahead is to implement these methods,” Basch said.

In addition to Basch, the other authors of the paper include John Spertus, MD, MPH, FACC of the University of Missouri in Kansas City; R. Adams Dudley, MD, MBA of University of California, San Francisco; Albert Wu, MD, MPH, of Johns Hopkins School of Public Health, Baltimore, MD; Cynthia Chuahan, a patient representative; Perry Cohen, a patient representative and project director of the Parkinson Pipeline Project; Mary Lou Smith, JD, MBA, a patient representative and co-founder of the Research Advocacy Network; Nick Black, MD, FFPH, FRCS of the London School of Hygiene and Tropical Medicine, London; Amaris Crawford, MPH, of the American Medical Association; Keri Christensen, MS, of the American Medical Association; Kathleen Blake, MD, MPH, of the American Medical Association; and Christine Goertz, DC, PhD, of the Palmer College of Chiropractic.

 The American Medical Association provided administrative support for the paper’s development.