Helping measure person-centred care - Health Foundation

1 Helping measure person- centred care A review of evidence about commonly used approaches and tools used to help measure person- centred care Evidence review March 2014. This research was commissioned and funded by the Health Foundation to help identify where and how improvements in healthcare quality can be made. This research was managed by: Darshan Patel, Research Manager 020 7257 8000. Author Dr Debra de Silva, The Evidence Centre A spreadsheet listing 160 of the most commonly researched measurement tools accompanies this review. Download the spreadsheet from: Helping measure person- centred care is published by the Health Foundation , 90 Long Acre, London WC2E 9RA.

2 2014 the Health Foundation Contents Key points 2. Part 1: Overarching themes 4. Chapter 1: Setting the scene 5. Chapter 2: Measuring person- centred care 11. Chapter 3: Thinking about the future 22. Part 2: Examples of measuring person- centred care 27. Chapter 4: Measurement approaches 28. Chapter 5: Measurement tools 34. Appendix and references 40. Appendix 1: Methodological approach 41. References 44. Helping measure PERSON- centred care 1. Key points This rapid review signposts to research about commonly used approaches and tools to help measure person- centred care .

3 It aims to showcase the many tools available for those working in policy and practice. What is person- centred care ? How is it measured? A person- centred Health system is one that supports The three most commonly researched ways to measure people to make informed decisions about, and to person- centred care are: successfully manage, their own Health and care , able to surveys and interviews with people using Health make informed decisions and choose when to invite others services to act on their behalf. This requires healthcare services to work in partnership to deliver care responsive to people's surveys of clinicians individual abilities, preferences, lifestyles and goals.

4 Observation of clinical encounters. Many strategies have been tested to help people be more A wide variety of unnamed surveys have been central to their care . Robust measurement is needed to developed to measure specific initiatives. There are understand the extent to which care is person- centred also an increasing number of named and validated and to help differentiate worthwhile initiatives. This tools for measuring person- centred care holistically as rapid review summarises themes from more than well as its specific components. The most commonly 23,000 studies about measuring person- centred care reported tools for measuring person- centred care are or its components.

5 Specific examples from 921 studies the Individualised care Scale, the measure of Processes are included. To source the material, two reviewers of care and the Person- centred care Assessment Tool. independently searched five bibliographic databases and screened more than 200,000 studies. To date, the largest proportion of studies about person- centred care have been conducted in a hospital context, but an increasing amount of research is exploring What is measured? person- centred care in primary care and community There is no universally agreed definition of person- centred services.

6 Nursing homes have also taken part in research. care in the empirical literature. Approaches to measuring person- centred care attempt to measure either the holistic Published research tends to have been undertaken by concept or specific subcomponents such as communication academic researchers, often working in partnership with or shared decision making (see Table 1). Health service teams as part of improvement initiatives or one-off research projects. Less has been published about Studies of person- centred care tend to focus on one of how clinical teams or Health organisations routinely four main issues: measure person- centred care as part of clinical practice.

7 Examining how patients or professionals define the components of person- centred care (definitions) Implications for the future examining the type of care that patients want or The key messages from this review are as follows. professionals' attitudes and values (preferences). A large number of tools are available to measure examining the extent to which care feels person- person- centred care , but there is no agreement about centred (experiences) which tools are most worthwhile. examining what happens as a result of person- There is no silver bullet' or best measure that covers centred care (outcomes).

8 All aspects of person- centred care . 2 THE Health Foundation . It is a priority to understand what person- centred ' care so these could be coupled with interviews with means. Until we know what we want to achieve, it is patients and clinicians or observation of clinical difficult to know the most appropriate way to measure it. encounters, perhaps annually. Combining a range of methods and tools is likely to Local testing is needed to examine the usefulness provide the most robust measure of person- centred of tools in the UK. Although many tools have been care .

9 Patient surveys could be used routinely in widely written about, this does not mean they are of practice, with results as part of quality scorecards good quality or useful for the UK context but there alongside indicators of safety and cost. Surveys alone is a good Foundation to begin from. do not provide the full picture about person- centred Table 1: Examples of approaches used to measure person- centred care and its components Concept Commonly researched measurement approaches Most commonly researched structured tools 1. Holistic concept of person- centred care Person- centred care / Surveys with professionals Individualised care Scale (ICS).

10 Patient- centred care Surveys with patients measure of Processes of care (MOPC). / individualised care Interviews with patients Person- centred care Assessment Tool / family- centred care Interviews with professionals (P-CAT). Focus groups Person- centred Climate Questionnaire Observation (PCCQ). Interviews with family Review of patient notes 2. Examples of subcomponents of person- centred care Patient satisfaction Surveys with patients Consumer Assessment of Healthcare / experience of care Interviews with patients Providers and Systems Hospital Survey Focus groups (CAHPS).