Dr. Lauren Lapointe-Shaw and IHPME Researchers Show Patients See the Bigger Picture in Hospital Care

What if hospitals asked patients not just what happened during their stay, but what should be improved? A new study led by Dr. Lauren Lapointe-Shaw suggests the answers could help reshape quality improvement efforts, revealing that patients and caregivers often prioritize the same system-level issues that concern clinicians when dealing with hospital care.

By: Marielle Boutin

The study, published in BMJ Quality and Safety, was guided by the team’s desire to better understand what patients and caregivers would want to improve in medical wards. To better understand how quality improvement efforts could be informed by patient priorities rather than organizational ones, the research team recruited over 500 patients and caregivers across 10 Canadian hospitals to provide feedback and share possible improvements in hospital care. The study’s findings indicated that while concerns related to personal wellbeing were mentioned, participants’ top priorities were broader systems-level issues such as delays in care, communication problems, and the need for greater inclusivity. 

According to Dr. Lapointe-Shaw, these findings are encouraging because they demonstrate that patients can help shape a patient-informed roadmap for strengthening hospital care at a systems level. 

“This really shows that patients and caregivers are able to distinguish between concerns that are narrowly anchored in their own experiences, and what may be more important broadly.” 

While “hotelling” issues such as bad food, noise, or discomfort were among the concerns raised, the study suggests participants were more focused on addressing barriers that could affect their long-term health. 

The study also suggests that priority-focused questions could be incorporated into hospital performance surveys, creating a stronger tool for quality improvement. 

Historically, hospital surveys have focused on “what happens” during stays, generally missing opportunities to ask patients what issues matter most to them or which they would prioritize for improvement.  

“It’s not that patients’ priorities are fundamentally misaligned with those of clinicians. The issue is that most current questionnaires don’t actually ask people what matters most to them,” says Dr. Lapointe-Shaw. “Instead, they assume that if someone reports a negative experience, that’s automatically an area they would prioritize for improvement.” 

This study makes a case for hospitals to make performance measurement more patient-driven by asking them to not only report their experience but identify what bigger picture issues they would like to see addressed. 

“I think a major opportunity is to move beyond asking people about their experiences and start asking them to identify their priorities within those experiences. That would be a meaningful enhancement to the surveys we currently use,” says Dr. Lapointe-Shaw. 

Ultimately, the study platforms patients and caregivers as credible partners in setting healthcare priorities.  

“They’re focused on things that impact their long-term health outcomes, which has more alignment with what clinicians would prioritize,” says Dr. Lapointe-Shaw. “I think it really shows that patients and caregivers can be trusted to draw this distinction between their own experience and what has broad importance.”