Patient-focused interventions: A review of the evidence

Patient-focused interventions are those that recognise the role of patients as active participants in the process of securing appropriate, effective, safe and responsive healthcare. Patients/citizens can contribute to quality improvement at both an individual and a collective level.

Patient-focused interventions are generally aimed at one or more of the following seven quality improvement goals, corresponding to the chapters in this report.

This contribution to the QEI project provides a concise and comprehensive overview of the evidence base for each of the above patient-focused interventions. In so doing, we aim to identify best practice and inform decision-making in healthcare policy, management, practice and research.

Patient-focused interventions are those that recognise the role of patients as active participants in the process of securing appropriate, effective, safe and responsive healthcare. There is a growing belief among policy-makers that patients/citizens can contribute to quality improvement at both an individual and a collective level.

As individuals or family members patients can play a distinct role in their own care by diagnosing and treating minor, self-limiting conditions; by preventing occurrence or recurrence of disease or harm; by selecting the most appropriate form of treatment in partnership with health professionals for more serious illness; and by actively managing long term conditions. Recognising these roles and seeking to strengthen them is seen as fundamental to securing a more patient-centred approach to healthcare delivery.

The collective engagement of patients or citizens can also be mobilised in the drive to monitor and improve quality standards and health outcomes. Fostering high standards of health literacy and a sense of ownership of their health may be the best way to ensure that people adopt healthier lifestyles, helping to meet health and behavioural targets as well as moderating demand for healthcare resources. Regular monitoring of patients’ experience of healthcare can provide organisations with a yardstick against which to measure the quality of their services. Offering patients choice and giving providers financial incentives to attract them is also seen as a means of driving up quality standards. Finally, it is believed that patient and public engagement in determining priorities for service development could help to ensure that policy-making keeps in tune with population requirements.

The QQUIP project

The review forms part of the Health Foundation’s programme to build and make public the knowledge base for quality and performance improvement. QQUIP (Quest for Quality and Improved Performance), is a new initiative, coordinated and funded by the Health Foundation, which will collect, analyse and report on a wide range of data about the quality and performance of healthcare provided in the UK. As a contribution to QQUIP, the Picker Institute was asked to produce an overview of the research evidence on the effectiveness of patient-focused interventions.

Patient-focused interventions are generally aimed at one or more of the following seven quality improvement goals: 

• improving health literacy
• improving clinical decision-making
• improving self-care
• improving patient safety 
• improving access to health advice
• improving the care experience 
• improving service development.

This contribution to the QQUIP programme aims to provide a concise and comprehensive overview of the evidence base for each of the above patient-focused interventions. In so doing, we hope to identify best practice and inform decision-making in policy, management, clinical practice and research