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

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

An unhappy patient suggests poor quality care, but Glyn Elwyn and colleagues point out that using measures of satisfaction to 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, that it is a service industry and has to pay more attention to those who use it. It may have unique features—in that it deals with high stake issues—but in common with other knowledge intensive services, it has to balance the expert skills with the expectations and experiential expertise of users. Service industries have learnt that sustained profitability stems from meaningful customer focus, collaboratively designed products and services, and positive interpersonal exchanges that management science calls "moments of truth."¹ Healthcare organisations are now keen to take patients' perspectives seriously, but it's not as simple as it may sound.

What do patients want?

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

Is what patients say they want the same as good quality care?

How does the UK compare with other countries?

How do we measure these quality issues?

Role of patients in assessing individual doctors

What happens if you pay doctors against patients' scores?

Summary points

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