title: How asking patients a simple question enhances care at the bedside: medical students as agents of quality improvement.
abstract: Medical students have traditionally played a passive role in the delivery of health care. The Institute for Healthcare Improvement Open School members and leaders initiated the Ask One Question project in December 2011. Through a commitment to the project, students are learning to assume a unique position in health care settings, as both learners and caregivers. They are improving care at the bedside by asking a simple question: "How can I improve your stay today?" Using the Model for Improvement to adapt the Ask One Question concept for local use, medical students at Cardiff University (United Kingdom) asked 120 patients. A content analysis of those responses identified 89 issues across 4 broad areas for improvement, including communication issues (uncertainty about their care management and desire for more time with their health care professional); practical issues (assistance with tasks made difficult because of ill health); wider organizational and National Health Services requests; and medical needs (requiring medical or nursing intervention). A medical student, a clinical colleague, or the hospital organization could act on those issues. Actions ranged from attending to simple tasks (eg, finding spectacles) or basic care needs (eg, giving a drink) to suggestions requiring wider institutional change. On a simple but effective level, Ask One Question reflects good manners and is a demonstrable competency of patient-centered practice. It is a vehicle for enabling students to seek improvements in health care and initiate relevant actions to improve the patient experience at the bedside.
authors.affiliation: Third-Year Clinical Medical Student at Cardiff University in Wales, United Kingdom. WardHO@cardiff.ac.uk.
authors.forename: Hope Olivia
authors.initials: HO
authors.lastname: Ward
authors.affiliation: Third-Year Clinical Medical Student at Cardiff University in Wales, United Kingdom. KibbleSL@cardiff.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kibble
authors.affiliation: Third-Year Clinical Medical Student at Cardiff University in Wales, United Kingdom. MehtaGV@cardiff.ac.uk.
authors.forename: Gney
authors.initials: G
authors.lastname: Mehta
authors.affiliation: Third-Year Clinical Medical Student at Cardiff University in Wales, United Kingdom. franklinM1@cardiff.ac.uk.
authors.forename: Marc
authors.initials: M
authors.lastname: Franklin
authors.affiliation: Third-Year Clinical Medical Student at Cardiff University in Wales, United Kingdom. KovoorJ@cardiff.ac.uk.
authors.forename: Joshua
authors.initials: J
authors.lastname: Kovoor
authors.affiliation: Senior Lecturer at the School of Nursing and Midwifery Studies in the College of Biomedical and Life Sciences at Cardiff University in Wales, United Kingdom. JonesA97@cardiff.ac.uk.
authors.forename: Aled
authors.initials: A
authors.lastname: Jones
authors.affiliation: Honorary Fellow at the Centre for Population Health Sciences at the University of Edinburgh in Scotland, United Kingdom. sukhmeet.panesar@surgicalmatrix.com.
authors.forename: Sukhmeet
authors.initials: S
authors.lastname: Panesar
authors.affiliation: Clinical Lecturer in Health Care Improvement at the Cochrane Institute for Primary Care and Public Health at Cardiff University in Wales, United Kingdom. andypcs@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Carson-Stevens
mesh_terms: D017028:Caregivers; D003142:Communication; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D013337:Students, Medical; D006113:United Kingdom; D014495:Universities