Department of Primary Care and Population Health, University College London, London, UK.
Collaboration for the Advancement of Medical Education Research and Assessment, Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
Health Expect. 2019 Apr;22(2):149-161. doi: 10.1111/hex.12852. Epub 2018 Dec 11.
Patient and public involvement (PPI) continues to develop as a central policy agenda in health care. The patient voice is seen as relevant, informative and can drive service improvement. However, critical exploration of PPI's role within monitoring and informing medical performance processes remains limited.
To explore and evaluate the contribution of PPI in medical performance processes to understand its extent, purpose and process.
The electronic databases PubMed, PsycINFO and Google Scholar were systematically searched for studies published between 2004 and 2018.
Studies involving doctors and patients and all forms of patient input (eg, patient feedback) associated with medical performance were included.
Using an inductive approach to analysis and synthesis, a coding framework was developed which was structured around three key themes: issues that shape PPI in medical performance processes; mechanisms for PPI; and the potential impacts of PPI on medical performance processes.
From 4772 studies, 48 articles (from 10 countries) met the inclusion criteria. Findings suggest that the extent of PPI in medical performance processes globally is highly variable and is primarily achieved through providing patient feedback or complaints. The emerging evidence suggests that PPI can encourage improvements in the quality of patient care, enable professional development and promote professionalism.
Developing more innovative methods of PPI beyond patient feedback and complaints may help revolutionize the practice of PPI into a collaborative partnership, facilitating the development of proactive relationships between the medical profession, patients and the public.
患者和公众参与（PPI）作为医疗保健的核心政策议程不断发展。患者的声音被认为是相关的、有信息的，可以推动服务的改善。然而，对于 PPI 在监测和告知医疗绩效过程中的作用的批判性探索仍然有限。
探索和评估 PPI 在医疗绩效过程中的贡献，以了解其范围、目的和过程。
系统地检索了 2004 年至 2018 年期间发表的 PubMed、PsycINFO 和 Google Scholar 电子数据库中的研究。
纳入了涉及医生和患者的研究，以及与医疗绩效相关的所有形式的患者投入（例如，患者反馈）。
使用归纳方法进行分析和综合，开发了一个编码框架，该框架围绕三个关键主题构建：塑造医疗绩效过程中 PPI 的问题；PPI 的机制；以及 PPI 对医疗绩效过程的潜在影响。
从 4772 项研究中，有 48 篇文章（来自 10 个国家）符合纳入标准。研究结果表明，全球范围内 PPI 在医疗绩效过程中的程度差异很大，主要通过提供患者反馈或投诉来实现。新兴证据表明，PPI 可以鼓励改善患者护理质量，促进专业发展并促进专业精神。
开发超越患者反馈和投诉的更具创新性的 PPI 方法可能有助于将 PPI 实践革命化为合作伙伴关系，促进医疗专业人员、患者和公众之间的积极关系的发展。
