A healthcare revolution is taking place. After decades of providing healthcare services, governments around the world are starting to accept that patients should have a strong voice in their own treatment and care pathway. Patient comfort, therefore, is becoming a priority for hospitals. Increasing patient satisfaction, improving outcomes and achieving ethical choices have become three essential milestones.

Quality time with patients

At the University of Kansas Hospital, the nursing staff is spending time with its patients before their hospital admission to discuss and understand the measures that will help them feel more comfortable during their hospital stay: the priority, therefore, is to take into consideration what really matters to the patient. Emphasis on comfort and quality of life can help to improve patients’ ability to better tolerate healthcare treatments and contribute to a greater sense of responsibility for the care process.

Priority assessment tools

In order to plan services with a patient focus, it is necessary to use methodology-based systems to get people’s opinions and invite them to present their views. It is not always easy to obtain considered answers due to personal prejudices and opinions that may change over time. At present, various quantitative and qualitative methods are used to collect patients’ views and more and more credit is given to the results of focus groups, surveys and questionnaires with open questions. Accurate, up-to-date and high quality information has to be provided to people to ensure reliability.

Questionnaire surveys have never been considered a high-level methodological tool. It is interesting to note that the British government has, since the beginning of the New Millennium, decided to listen to its patients by sending questionnaires to 100,000 people to assess their experience of general medical care.

The patient’s priority in research

Patients are also increasingly involved in the different steps of the research process and are acknowledged as ‘experts’. This classification stems from the understanding that affected individuals bear the burden of disease and therefore have the right to participate in the process of determining the cure.

Being able to address real problems in health care more adequately through patient empowerment increases the chances that scientific achievements will be carried out in practice, thus leading to a more efficient use of financial resources. According to the paradigm shift mentioned above, an increasing number of efforts are being developed to include patients, physicians and healthcare professionals in the process of identifying research priorities.

Patient and public involvement in Europe

European healthcare systems are starting to show an active and growing interest in introducing Patient and Public Involvement (PPI) to actively involve patients in healthcare decisions. In the Old Continent, two good examples of this new approach are the United Kingdom and the Netherlands.

Great Britain launched the institutional case study INVOLVE in 1996 with the aim of promoting active public participation in the English health service and to date it is one of the very few programmes funded by a state government.

The Netherlands has been involving patients in research and health policy since 1997 through the Lung Foundation Netherland. In 2007, an advisory committee consisting of patients with lung disease was founded; it actively participates in the creation of standards and guidelines for care with simplified language, the determination of research priorities, the development of criteria for the evaluation of the patient perspective and the evaluation of research proposals.

Prioritising the patient in the care of the elderly

The Centre for Geriatric Medicine at the Cleveland Clinic has become the first primary care centre to test a patient priorities approach to the care of geriatric patients with multiple chronic conditions. Patient Priorities Care (PPC) is based on the idea that older people should establish priorities for their own care together with their physician. This kind of approach has proven, in a short time, to improve patient satisfaction and reduce healthcare costs at the same time.

The strength of PPC is the quality of managing a patient’s condition based on dialogue with the physician and with a focus on the patient’s personal priorities. The physician can ask the patient, for example, “What is the number one change you want to see as a result of your treatment?” — the answer will allow the physician to identify the best treatments that will help the patient achieve the goal.

The PPC approach also benefits clinicians, who are more relieved of the pressure of having to obtain results based on general guidelines but not in line with patient goals. Basing quality metrics no longer on unrealistic and unattainable goals but on patient priorities therefore guarantees higher satisfaction scores and a lower and easier stress threshold for the physician. This will also enable him/her to achieve better results in the field.

Clearly, this patient-centred approach throughout the entire treatment cycle brings with it a number of significant benefits. These include not only an increase in the success rate of therapies, but also a cognitive and psychological wellbeing of the patient that can reflect positively on the staff of the hospital in charge of the admission.