Respecting the subjective: quality measurement from the patient's perspective

doi:10.1136/bmj.39339.490301.AD

BMJ 2007;335:1021-1022 (17 November), doi:10.1136/bmj.39339.490301.AD

Analysis

Measuring quality through performance

Respecting the subjective: quality measurement from the patient's perspective

Glyn Elwyn, professor¹, Stephen Buetow, director of research², Judith Hibbard, professor³, Michel Wensing, senior researcher⁴

¹ Department of Primary Care and Public Health, Cardiff University, Cardiff CF14 4YS, ² Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand, ³ Department of Planning, Public Policy, and Management, University of Oregon, Eugene, Oregon, USA, ⁴ Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

Correspondence to: G Elwyn elwyng@cardiff.ac.uk

An unhappy patient suggests poor quality care, but Glyn Elwynand colleagues point out that using measures of satisfactionto assess health providers is not without problems

The first 150 words of the full text of this article appear below.

Modern health care is recognising, albeit with difficulty, thatit is a service industry and has to pay more attention to thosewho use it. It may have unique features—in that it dealswith high stake issues—but in common with other knowledgeintensive services, it has to balance the expert skills withthe expectations and experiential expertise of users. Serviceindustries have learnt that sustained profitability stems frommeaningful customer focus, collaboratively designed productsand services, and positive interpersonal exchanges that managementscience calls "moments of truth."¹ Healthcare organisationsare now keen to take patients' perspectives seriously, but it'snot as simple as it may sound.

Reviews of patient priorities are consistent.² Summarised, theystate that patients assume technical competence at both professionaland organisational levels. Patients admit difficulty in judgingwhether these assumptions are met, although they further assumethat systems are in place to ensure that basic standards . . . [Full text of this article]

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