Patient experience as an indicator of clinical quality in emergency care

Abstract

Abstract Purpose There is growing focus on the importance of attending to "patient experience" in delivery of health services, and the design of clinical quality indicators. "Patient experience" (also termed "user experience") has been augmented by "staff" and "carer" experience in the "service experience" quality indicator for emergency care in England. But "patient experience" is a contested concept which patients, clinicians, politicians, managers and academics view differently. Design/methodology/approach The purpose of this paper is to examine approaches to thinking about patient experience. The author describes three key approaches to conceptualising patient experience and identify their philosophical origins, then asks what aspects of patient experience ought to be treated as key to measuring the quality of emergency care. The discussion is illustrated with extracts from a patient interview describing emergency care following placental abruption.The author demonstrates that differing purposes and differing conceptions of care direct attention to different aspects of patient experience. Findings Donabedian's insight was that conceptions of quality are inevitably related to conceptions of value and the author concurs, arguing that decisions about which aspects of patient experience to include in clinical quality indicators are ethical as well as technical judgements. Practical implications This paper is of value to those concerned with quality improvement because it clarifies the meaning of patient experience in the context of care quality measurement, and highlights the ethical implications of experiential data. Originality/value It is a novel synthesis of understandings of patient experience and clinical quality in emergency care.