Using patient input in a cycle for performance improvement.

BACKGROUND

To effectively use patient input to improve performance, an organization needs a systematic method for gathering, assessing, and using those data to improve old processes and design new ones. This method should include the stages in the Joint Commission on Accreditation of Healthcare Organization's cycle for improving performance. It is important to remember that using patient input to improve performance is not an isolated activity but should be linked, in the organization's strategic plan as well as in its practice, to organizationwide efforts to improve performance.

DESIGN

Designing a process to use patient input in performance improvement requires reviewing the patient groups served by the organization, the important clinical and organizational functions that affect patients, the dimensions of performance that affect patients in each function, and the possible methods for gathering and using patient input.

MEASURE

The measurement method varies depending on the process, patient group, diagnosis, or other subject being measured. Any plan for measurement, including one for gathering patient input, should address the following questions: What data will be collected? Who will be involved in the collection? When, where, and how will the data be collected? ASSESS: Raw data cannot be the basis for improving performance but must be carefully assessed to provide information about current performance, identify opportunities for improvement, help set priorities, and help identify root causes of problems that can lead to improvement. IMPROVE: Whether using patient input to design a new process or to redesign an existing process, the goal is to translate patient input into specific characteristics (key quality characteristics) that can be addressed by the improvement plan. Once a new or redesigned process has been implemented, teams must measure its effect. This measurement often involves going back to patients and collecting feedback to see if the process is meeting their needs and expectations, usually through a written or telephone survey. To develop an instrument to measure satisfaction, staff can return to the specifications and indicators they developed based on patients needs and expectations.