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Putting the Patient Voice at the Heart of Service Redesign: an introduction to the use of patient reported measures to improve person centred coordinated (integrated) care

Authors:
lloyd, H et al 2018 Putting the Patient Voice at the Heart of Service Redesign:
an introduction to the use of patient reported measures to improve person
centred coordinated (integrated) care..
International Journal of Integrated
Care
, 18(S2): A34, pp. 1-8, DOI: dx.doi.org/10.5334/ijic.s2034
CONFERENCE ABSTRACT
Putting the Patient Voice at the Heart of Service Redesign: an introduction
to the use of patient reported measures to improve person centred
coordinated (integrated) care.
18th International Conference on Integrated Care, Utrecht, 23-25 May 2018
Helen Mary lloyd, Ben Fosh
Community and Primary Care Research Group, Plymouth University, United Kingdom
Background: Patient Reported Measures (PRM) are questionnaires that were originally
designed as research tools to measure the outcomes of intervention studies (1). This often
encompassed measuring treatment satisfaction or symptoms from the perspective of the
patient. PRMs have now evolved into a diverse range of tools measuring constructs such as
health quality of life (HQoL), self-defined health status, illness experiences and evaluations
of care delivery. Current UK health policy strongly advocates the use of PRMs to drive the
redesign of new models of integrated or Person Centred and Coordinated Care. If chosen
wisely and linked to a theory of change, these tools can help improve care delivery through a
variety of novel ways, including system-level feedback for healthcare management and
commissioning and delivery level improvements in care planning for individual patients (2). This
can be particularly useful for individuals with long term conditions and complex health and
social needs (3-5). Using such measures within healthcare settings can however be
problematic, with support and guidance required to maximise their potential contribution for
quality improvement (6).
Aims and Objectives: This interactive session will provide an overview of how measures can be
used in practice, the evidence base for their use and practical guidance about how to access
and implement measures:
a) Prese nt the i ntern a tiona l evide nce fo r using PRMS t o improve the delivery of Person centred
coordinated care
Discussion (5 mins.)
b) Outline the ways in which PRMS can be used to support the development of care
Discussion (5 mins.)
c) Discuss the problems, barriers and facilitators to implementing PRMS
Discussion (10 mins.)
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lloyd; Putting the Patient Voice at the Heart of Service Redesign: an introduction to the use
of patient reported measures to improve person centred coordinated (integrated) care.
Target audience: Researchers, health and social care commissioners and professionals who are
either evaluating or delivering models of integrated or person centred care.
Learnings/Take away:
a) An understanding of the evidence for using the patient voice via patient reported measures
to drive quality improvement in service redesign efforts.
b) Practical guidance on how to find and use suitable measures and an appreciation of some of
the barriers and facilitators to their use.
Keywords: patient reported measures; quality improvement; patient reported outcomes; data driven
improvement
Article
This paper argues that one aspect of re‐imagining evaluation in health planning and management is for leaders and clinicians to develop comfort with vulnerability when engaging in service evaluations. Starting with an exploration of how the service user voice is traditionally expressed in healthcare evaluation, the paper then proceeds to explore the particular role and challenges faced by clinician‐evaluators, including their role as ‘privileged interlocutors’ in conversations with service users. The tensions in reconciling the role of the clinician as an expert, with the related but different skills needed for effective discourse in qualitative evaluation are explored, and it is asserted that it is important for clinicians and leaders to be comfortable in showing and working with vulnerability when evaluating healthcare interventions. Clinicians are already skilled in holding discourse with service users, and extending the communication repertoire to include the management of emotion and expression of vulnerability is achievable and rewarding. The paper concludes that the ability to hold a vulnerable stance when conducting evaluation can have benefits in reducing defensiveness, encouraging a truer sense of enquiry and amplifying the service user voice.
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