Quality improvement in New Zealand healthcare. Part 6: keeping the patient front and centre to improve healthcare quality.

Patient-centred care is arguably the most important of the dimensions of quality as it is likely that a healthcare system which is patient-centred will also perform well against the other dimensions--safety as well as timely, accessible, effective, and efficient care. What does it mean to be patient-centred and how can it be achieved? This article explores several definitions of patient-centred care and discusses two interpretations--the expert patient and shared decision-making. Being sick is inherently a vulnerable position to be in and our current healthcare system does little to recognise and alleviate this vulnerability. But the patient-centred approach is about more than making the journey for patients less tortuous, it has actually been shown to improve outcomes. The evidence of benefit for a patient-centred approach is reviewed, along with some of the challenges in implementing the concept in practice.