Session 4 of the ACQUIRE Quality Improvement (QI) Leadership Forum 2024 examined the pivotal role of patient-centered care (PCC) and the impact of engaged leadership on advancing quality initiatives. Led by Benta Omonge, a Certified Patient Experience Professional (CPXP) with the Patient Experience Institute, USA, this session emphasized the transformative potential of placing patients at the heart of healthcare delivery. By focusing on patient-centered approaches, the discussion highlighted how healthcare systems can build trust, enhance health outcomes, and ensure services are genuinely responsive to community needs.
Defining Patient-Centred Care and Experience
Opening the session, Benta Omonge, Certified Patient Experience Professional (CPXP) from the Patient Experience Institute, USA, shared a core principle that guides patient-centered care: delivering care that we ourselves would want to receive. Patient experience, as defined by practitioners, is the sum of all interactions shaped by an organization’s culture and directly influences a patient’s perception across their care journey. “The patient is at the center of the healthcare system,” Ms. Omonge emphasized, “because patient experience and workforce are inseparable.”
Patient experience isn’t only about clinical outcomes but the holistic experience that includes factors outside of medical treatment. Research indicates that 80% of health outcomes are shaped by factors outside direct medical intervention, underscoring the importance of training staff to engage patients and their families effectively and counter biases that hinder good experiences.
Key Strategies for Embedding Patient-Centred Care
Ms. Omonge outlined several strategic actions healthcare facilities can take to prioritize PCC and drive impactful QI initiatives:
- Identify and Support Accountable Leaders: Designate individuals to oversee patient experience and ensure it remains a priority.
- Define Patient Experience Formally: Establish a clear, organization-wide definition of patient experience to provide direction.
- Foster a Patient-Centred Culture: Create a strong organizational culture as the foundation for a successful patient experience.
- Engage Patients, Families, and Communities: Implement processes for continuous engagement, making patient and family voices central to all experience efforts.
- Align Health Equity and Access to Care: Prioritise health equity and ensure all patients have access to quality care.
- Promote Wellness Beyond Illness: Focus on holistic health and wellness, not just treating illness.
- Address the Full Continuum of Care: Recognize that patient experience extends beyond clinical encounters to every touchpoint across the healthcare journey.
These strategies align with four critical aspects that leadership measures in healthcare: clinical outcomes, financial performance, customer satisfaction, and community reputation. “Reputation drives choices, and today’s patients have a wide range of options, making experience a deciding factor,” Ms. Omonge noted.
Measuring What Matters in Patient-Centred Care
To improve PCC, Ms. Omonge introduced quality management standards and specific metrics that evaluate risk, patient safety, and nurse-specific indicators, such as patient falls, pressure ulcer formation, and healthcare-associated infections (HAIs). These indicators are essential in determining the quality of care delivered, with significant implications for patient safety and clinical outcomes.
The Institute of Medicine (IOM) supports six dimensions of patient-centeredness that address the nature of care:
Benta noted that several tools can help measure these elements, including the Consumer Assessment of Healthcare Providers Systems (CAHPS), the Net Promoter Score, and the Global Experience Measuring Tool. These tools offer a framework for healthcare providers to monitor patient-centeredness effectively.
Enhancing Facility-Level Engagement in PCC
A patient-centered approach hinges on the continuous engagement and commitment of healthcare facilities to align their practices with PCC goals. Achieving this requires a strategic framework of deliberate actions that guide both leadership and staff toward fostering a patient-first culture. Key pillars of this framework include:
- Top Leadership Support: Strong, dedicated leadership is critical in securing budget allocations and aligning the organization with PCC objectives. Leaders set the tone, ensuring that PCC is woven into every level of the facility.
- Empowering Frontline Staff: Training staff in essential skills—such as service recovery, patient communication, and engagement—is foundational for a patient-centered culture. Frontline employees, being closest to patients, need these tools to respond effectively to patient needs and maintain a culture of continuous improvement.
- Internal Audits and Continuous Improvement: Regular audits and reviews offer essential insights into progress and help refine PCC practices. These audits form the basis for action plans, reviewed quarterly or bi-annually, to ensure that patient-centered goals are consistently met.
- Healthcare facilities can reinforce engagement through town halls, symposiums, and public participation events to gather feedback and align services with community needs. Departmental PCC champions and resources—like short videos, podcasts, and literature—keep PCC practices front of mind and accessible, fostering a culture of openness and inclusivity.
Research and the Role of Leadership in Quality Improvement
Dr. Jackline Alidi, a Health Systems Researcher, underscored the importance of Patient-Centred Quality Indicators (PC-QIs)—metrics that evaluate healthcare quality from the perspective of patients and caregivers. Sharing findings from studies conducted across Ghana, Guinea, Nigeria, and Kenya, Dr. Alidi showed how disparities, such as gender and social inequalities, significantly shape patient experiences. However, PC-QIs are often inconsistently defined and applied, presenting a major challenge in standardizing patient-centered measures.
“We need standardized tools that can lead to actionable changes,” Dr. Alidi remarked, highlighting the need for validated, locally relevant tools to provide effective benchmarks for patient-centered care. She emphasized that without standardized indicators, translating subjective patient experiences into objective QI metrics becomes nearly impossible.
Another critical insight from Dr. Alidi’s research was the impact of healthcare staff stress and burnout on care quality. Stress among healthcare workers affects their ability to provide quality care, yet it is often overlooked in QI planning. Research funding for stress and burnout studies is crucial, allowing health systems to develop interventions that address these underlying issues, ultimately supporting both staff and patient well-being.
The Patient’s Voice: Building a QI Culture in Healthcare
As the session concluded, participants discussed the importance of maintaining patients’ rights charters and raising awareness among patients and staff alike. Leadership’s role in implementing the charter ensures that patient rights are protected, respected, and integrated into daily practice.
In closing, Dr. Alidi posed a call to action: “Do we need to define patient experience differently to address the unique needs of our region?” This question encourages healthcare systems to adopt or customize patient experience measurement tools that reflect regional specificities. Establishing institutional baselines for patient experience is essential for facilities to track and facilitate improvements effectively. By bringing back the voices of patients and families, African health systems can build resilience and deliver truly patient-centered care.
