How might we harness the power of patient experience to drive improvements in care?

Much more can be done to use patient experience as a driver for improving quality of care, so say Angela Coulter and colleagues in a thoughtful BMJ analysis.

So, where do we start?

Professor Coulter and colleagues advocate for a national institute of ‘user’ experience. Indeed, this could provide a catalyst for bringing together different strands of work (quantitative/qualitative/using different data sources (e.g., GPPS, CQC, NCPS)) in a co-ordinated manner and, ultimately, to strengthen the use of patient experience as a driver of improvements in care.

In addition to the potential benefits of a stronger institutional focus as emphasised by Angela Coulter and colleagues, I would add one further suggestion: that better use of patient experience should be made in the design and commissioning of health services. This, in my view, may be one of the most effective ways to ensure that information on patient experiences is not only collected but, more importantly, that it used to good effect in improving care.

At present, we have a strong emphasis on using patient experience to evaluate health services, but less attention has been given to exploiting the potential benefits of using patient experience to improve care at the much earlier stage of service design. There may be important benefits from involving patients more actively and as equal partners at the start (service design), not just the end (service evaluation), particularly given the limited evidence that a focusing on measuring patient experience as part of service evaluation, alone, translates into meaningful improvements in care.

As a minor point, I am not entirely convinced by the authors’ observation that ‘the strong policy focus on measuring experiences has not been matched by a concerted effort to develop the science that should underpin it.’ I have a slightly more optimistic view, based on recent literature. In the last few years there have been important developments in the ‘science’ of patient experience. For example, scientific papers have: (1) expanded our knowledge of factors that influence patients’ experiences; (2) helped us to understand the impact of adjusting patient experience ratings for case-mix in order to make fair comparisons between providers; and (3) contributed to better understandings of what matters most to patients.

Finally, thanks to Angela Coulter and colleagues for a thought-provoking paper emphasising that collecting data on patient experience is not enough, and challenging us to do better!

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