Nuti Sabina, De Rosis Sabina, Bonciani Manila, Murante Anna Maria
Full Professor, Laboratorio Management e Sanità, Institute of Management, Sant'Anna School of Advanced Studies, Pisa, Italy.
Laboratorio Management e Sanità, Institute of Management, Sant'Anna School of Advanced Studies, Pisa, Italy.
Healthc Pap. 2017 Oct;17(2):56-64. doi: 10.12927/hcpap.2017.25408.
Patient experience should be the starting point to achieve a high quality of care. Coherently, healthcare performance evaluation systems, driving the change in line with the main strategic goals, should be designed considering the patient perspective. Instead, they are traditionally defined according to the healthcare service provider's point of view. Consequently, they reproduce a "silo-vision" characterized by a clear separation of responsibilities limited to a specific setting of care or to a single organization. This commentary discusses the importance of using patient-reported measures together with indicators based on administrative data to evaluate cross-setting healthcare services within a multidimensional healthcare performance evaluation system. The experience of the Tuscany regional healthcare Performance Measurement System (PMS), implemented more than 10 years ago and in continuous evolution, represents an innovative example of how to measure the quality of the whole care pathway including patient experience. This new approach is based on a systematic, systemic and standardized collection of patient-reported experience measures in several healthcare pathways and evaluating them using a coherent graphical representation. Targets, incentives and other managerial tools are fixed, overcoming organizational boundaries and integrating the patient point of view with the goal of moving the healthcare system towards a patient-centredness approach to care.
患者体验应成为实现高质量医疗服务的出发点。相应地，推动变革以符合主要战略目标的医疗绩效评估系统，在设计时应考虑患者的视角。然而，传统上它们是根据医疗服务提供者的观点来定义的。因此，它们呈现出一种“竖井式视角”，其特点是责任明确划分，仅限于特定的医疗环境或单个组织。本评论讨论了在多维度医疗绩效评估系统中，将患者报告的指标与基于行政数据的指标结合使用，以评估跨环境医疗服务的重要性。托斯卡纳地区医疗绩效评估系统（PMS）于十多年前实施且不断发展，其经验代表了如何衡量包括患者体验在内的整个医疗路径质量的一个创新范例。这种新方法基于在多个医疗路径中对患者报告的体验指标进行系统、全面和标准化的收集，并使用连贯的图形表示法对其进行评估。设定目标、激励措施和其他管理工具，打破组织界限，将患者视角与推动医疗系统向以患者为中心的护理方式转变的目标相结合。
