Person-centred quality indicator | Round 1: prioritization (N = 10) | Round 2: discussion (N = 11) | Round 3: prioritization (N = 11) | ||||
---|---|---|---|---|---|---|---|
Rank (frequency in Top 5) | Median (IQR) | Stakeholder group priority | Rank (frequency in Top 5) | Median (IQR) | Stakeholder group priority | ||
Structure indicators | |||||||
S1. Policy on person-centred care | 13 (1) | 1 (1–1) | 1 PCN | Concern where policy is sometimes at odds with patient care and at times even PCC (what matters to the patient) | 10 (2) | 3 (2–4) | 1 Patient; 1 PCN |
Policy as a necessary overarching structure that will enable are more shared understanding of PCC and goals for improvement | |||||||
Importance of having both policy, which comes from the top, as well as a grassroots movement to see actual improvements | |||||||
S2. Educational programs on person-centred care | 13 (1) | 1 (1–1) | 1 PCN | Important to bring the healthcare workforce on the same page in terms of understanding PCC and it is both actionable and measurable | 12 (1) | 2 (2–2) | 1 PCN |
Education could fall under S7. Structures to report on PCC Performance | |||||||
S3. Culturally competent care | 3 (4) | 1.5 (1–2.25) | 1 Physician; 2 Patient; 1 PCN | Concern about measuring this as it can be delicate and will mean different things to different people. It may be challenging to measure various aspects of culturally competent care in a way that is tangible and meaningful | 7 (4) | 3 (2.75–3.25) | 1 Patient; 1 Physician; 2 PCN |
S4. Providing an accommodating and supportive person-centred care environment | 15 (1) | 5 (5–5) | 1 Patient | (Not discussed) | N/A | N/A | N/A |
S5. Co-designing care in partnership with communities | 4 (4) | 2 (1.75–2.75) | 1 Clinic QI Staff; 2 Patient; 1 Physician | (Not discussed) | 4 (7) | 4 (4–4) | 2 Patient; 3 Physician; 2 QI Staff |
S6. Health information technology to support person-centred care | 1 (5) | 3 (1–4.25) | 2 Clinic QI Staff; 2 PCN, 1 Physician | (Not discussed) | 3 (7) | 3 (1–3.5) | 3 Patient; 2 Physician; 2 PCN; 1 QI Staff |
S7. Structures to report person-centred care performance | 9 (3) | 4 (4.5–5) | 1 Clinic QI Staff; 1 PCN; 1 Physician | (Not discussed) | 13 (1) | 5 (5–5) | 1 PCN |
Process indicators | |||||||
P1. Compassionate care | 7 (3) | 3 (2.5–3) | 1 Patient;1 PCN, 1 Physician | (Not discussed) | 9 (2) | 1.5 (1.25–1.75) | 1 Patient; 1 QI Staff |
P2. Equitable treatment | 6 (3) | 2 (2–3) | 2 Patient; 1 Physician | (Not discussed) | 8 (4) | 4.5 (3.5–5) | 2 Patient; 1 Physician; 2 PCN |
P3. Trusting relationship with healthcare provider | 5 (4) | 2.5 (1–4.25) | 1 Clinic QI Staff; 2 Patient; 1 Physician | (Not discussed) | 2 (7) | 1 (1–2.5) | 2 Patient; 2 Physician; 2 PCN; 1 QI Staff |
P4. Accessing interpreter services | N/A (0) | N/A | N/A | (Not discussed) | N/A | N/A | N/A |
P5. Communication with healthcare system | 11 (2) | 3.5 (3.25–3.75) | 2 Clinic QI Staff | (Not discussed) | N/A | N/A | N/A |
P6. Communication between patient and healthcare provider – nurse | N/A (0) | N/A | N/A | (Not discussed) | N/A | N/A | N/A |
P7. Communication between patient and healthcare provider – physician | 14 (1) | 2 (2–2) | 1 Patient | (Not discussed) | N/A | N/A | N/A |
P8. Information about taking medication | N/A (0) | N/A | N/A | (Not discussed) | N/A | N/A | N/A |
P9. Communicating test results | 13 (1) | 1 (1–1) | 1 PCN | (Not discussed) | N/A | N/A | N/A |
P10. Coordination of care | 8 (3) | 4 (4–4.5) | 1 Patient; 1 PCN, 1 Physician | (Not discussed) | N/A | N/A | N/A |
P11. Patient and caregiver involvement in decisions about their care and treatment | 2 (5) | 3 (3–4) | 3 Patient; 2 PCN | Important for patients to work with their family physician on care and treatment as there is a long-term relationship. This can be considered as an umbrella indicator that would include things like compassionate care, communication, etc | 1 (10) | 3 (2–4.5) | 3 Patient; 3 Physician, 3 PCN; 1 QI Staff |
P12. Engaging patients in managing their own health | 15 (1) | 5 (5–5) | 1 PCN | (Not discussed) | N/A | N/A | N/A |
P13. Timely access to a primary care provider | 10 (2) | 2 (1.5–2.5) | 1 Clinic QI Staff; 1 PCN | Surprise about the low prioritization as this may be important to patients | 6 (4) | 2.5 (1.75–3.5 | 1 Patient; 1 Physician; 2 QI Staff |
Patients tend to be happy with their care if they have access/they have a doctor (so experience results can be biased) | |||||||
Panelists shared experiences with this indicator not actually resulting in real improvements/changes | |||||||
P14. Patient preparation for a planned treatment program | N/A (0) | N/A | N/A | (Not discussed) | N/A | N/A | N/A |
P15. Transition planning | N/A (0) | N/A | N/A | (Not discussed) | N/A | N/A | N/A |
P16. Using patient-reported outcomes to deliver patient-centred care | 12 (2) | 2 (1.5–2.5) | 1 Clinic QI Staff; 1 PCN | (Not discussed) | N/A | N/A | N/A |
Outcome indicators | |||||||
O1. Overall experience | 13 (1) | 1 (1–1) | 1 Clinic QI Staff | It would be important to be able to evaluate a patient’s whole journey as they interact with various aspects of the healthcare system (not just communication with nurse or physician) | 5 (5) | 3 (3–4) | 1 Patient; 1 Physician; 2 PCN; 1 QI Staff |
O2. Cost of care - affordability | 15 (1) | 5 (5–5) | 1 PCN | (Not discussed) | N/A | N/A | N/A |
Global indicator: friends and family test | 13 (1) | 1 (1–1) | 1 Physician | (Not discussed) | N/A | N/A | N/A |