Singh Hardeep, Arora Neeraj K, Mazor Kathleen M, Street Richard L
Houston VA Health Services Research & Development; Baylor College of Medicine,
Patient Centered Outcomes Research Institute (PCORI),
Patient Exp J. 2015 Fall-Winter;2(2):125-131.
The Veterans Health Administration (VHA) is charged with providing high-quality health care, not only in terms of technical competence but also with regard to patient-centered care experiences. Patient-centered coordination of care and communication are especially important in cancer care, as deficiencies in these areas have been implicated in many cases of delayed cancer diagnosis and treatment. Additionally, because cancer care facilities are concentrated within the VHA system, geographical and system-level barriers may present prominent obstacles to quality care. Systematic assessment of patient-centered communication (PCC) may help identify both individual veterans who are at risk of suboptimal care and opportunities for quality improvement initiatives at the service, facility, or system-wide level. In this manuscript, we describe our vision to implement an assessment of PCC through patient self-report to improve the quality of cancer care and other health services in the VHA. We outline a possible strategy to assess PCC that leverages the VHA's existing initiative to promote use of an online personal health record for veterans (MyHealthVet). Questionnaires administered periodically or following specific episodes of care can be targeted to assess PCC in cancer care. Assessment of PCC can also be tied to clinical and administrative data for more robust analysis of patient outcomes. Ultimately, the goal of any assessment of PCC is to gather valid, actionable data that can assist VHA clinicians and staff with providing the best possible care for veterans with cancer.
退伍军人健康管理局（VHA）负责提供高质量的医疗保健服务，不仅要具备技术能力，还要提供以患者为中心的就医体验。在癌症护理中，以患者为中心的护理协调和沟通尤为重要，因为这些领域的不足在许多癌症诊断和治疗延迟的案例中都有涉及。此外，由于癌症护理设施集中在VHA系统内，地理和系统层面的障碍可能会给优质护理带来突出的阻碍。对以患者为中心的沟通（PCC）进行系统评估，可能有助于识别那些有接受次优护理风险的退伍军人个体，以及在服务、机构或全系统层面开展质量改进举措的机会。在本手稿中，我们描述了通过患者自我报告来实施PCC评估的愿景，以提高VHA中癌症护理和其他健康服务的质量。我们概述了一种评估PCC的可能策略，该策略利用VHA现有的倡议，以促进退伍军人使用在线个人健康记录（MyHealthVet）。定期或在特定护理事件后发放的问卷可以针对性地评估癌症护理中的PCC。对PCC的评估还可以与临床和管理数据相关联，以便更全面地分析患者的治疗结果。最终，任何PCC评估的目标都是收集有效、可操作的数据，以帮助VHA的临床医生和工作人员为患癌退伍军人提供尽可能最好的护理。
