title: Collaborative Patient-Centered Quality Improvement: A Cross-Sectional Survey Comparing the Types and Numbers of Quality Initiatives Selected by Patients and Health Professionals.
abstract: Identification of patients' and health professionals' quality improvement preferences is an essential first step in collaborative improvement models. This includes experience-based codesign (EBCD), where service change is strategically introduced following stakeholder consultation. This study compared the number and types of improvement initiatives selected by outpatients and health professionals. Using electronic surveys designed to inform EBCD studies, 541 outpatients (71.1% consent) and 124 professionals (47.1% response) selected up to 23 general initiatives. On average, outpatients selected 2.4 (median = 1, interquartile range = 1-3) initiatives and professionals selected 10.7 (median = 10; interquartile range = 6-15) initiatives. Outpatients demonstrated a strong preference for improvements to clinic organization, such as appointment scheduling and clinic contact. Outpatients selected relatively fewer initiatives potentially reducing the complexity of service change and resources required to address preferences. Comparatively, professionals indicated a greater degree of change is needed and selected initiatives related to communication with patients and other professionals, including coordinating multidisciplinary care. Improvements to information provision were commonly selected by both groups and offered a strategic opportunity to address patients' and professionals' preferences. By quantifying the ways in which preferences differed, this study emphasizes the need for collaborative approaches to health service change and may be used to initiate an informed discussion on patients' and professionals' quality improvement preferences in tertiary care.
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia elizabeth.fradgley@newcastle.edu.au.|Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Fradgley
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.|Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Paul
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.|Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Bryant
authors.affiliation: Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Local Health District, New Lambton, New South Wales, Australia.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Collins
authors.affiliation: Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.|Department of Medical Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Ackland
authors.affiliation: Cancer Network, Hunter New England Local Health District, New Lambton, New South Wales, Australia.
authors.forename: Douglas
authors.initials: D
authors.lastname: Bellamy
authors.affiliation: Department of Neurology, John Hunter Hospital and Research Support and Development Unit, Hunter New England Local Health District, New Lambton, New South Wales, Australia.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Levi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D003142:Communication; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D055815:Young Adult
keywords: ambulatory care; consumer participation; experience-based design; health-care surveys; patient-centered care; quality improvement