Incorporating the Patient Voice Into Practice Improvement:

Abstract

Background and Objectives: Many primary care clinics rely on providers and staff to generate quality improvement (QI) ideas without explicitly including patients. However, without understanding patient perspectives, clinics may miss areas for improvement. We identified practice improvement opportunities using a medical student-driven pilot of QI design that incorporates the patient voice and explored provider/staff perceptions of patient perspectives. Methods: One medical student interviewed eight patients for their perspectives on QI opportunities at a university-based primary care practice. Two trainees independently coded interview transcripts using directed content analysis (final codebook: 11 themes) and determined frequency of mentions for each theme. We surveyed 11 providers/staff by asking them to select 5 of the 11 themes and place them in rank order based on their perceptions of patient concerns; their surveys were aggregated into one ranked list. Results: Patients most frequently identified the following themes as QI opportunities: relationship (ie, feeling of personal connection with providers/staff), specialty care, convenience, sustainability, and goal follow-up. While patients frequently identified relationship (rank=1) and goal follow-up (rank=3) as QI opportunities, the provider/staff top five list did not include relationship (rank=10) or goal follow-up (rank=7). Conclusions: Our study demonstrates two things: (1) there are areas of discordance between provider/staff perceptions and patient perspectives regarding practice improvement opportunities; and (2) medical students can participate meaningfully in the QI process. By harnessing patient perspectives with the help of medical trainees, clinics may better understand patient concerns and avoid potential QI blind spots.

Using the AHEC Scholars Program to Enhance Health Professions Learners’ Self-Efficacy for Practice Transformation

“…The community-based, facilitated approach to practice transformation benefits multiple stakeholders within the community. 11 The challenge remains that health professions academic training curriculums are complex and often provide limited opportunities for students to learn about and engage in practice transformation. The AHEC Scholars program provides learners with community-based opportunities to augment their traditional academic training curriculum on practice transformation, as well as, social determinants of health, interprofessional team-based care, and cultural competency.…”