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A systematic review of evidence on the links between patient experience and clinical safety and effectiveness

Cathal Doyle, Derek Bell, Laura Lennox

BMJ Journals

Objective: To explore evidence on the links between patient experience and clinical safety and effectiveness outcomes. Design: Systematic review. Setting: A wide range of settings within primary and secondary care including hospitals and primary care centres. Participants: A wide range of demographic groups and age groups. Primary and secondary outcome measures: A broad range of patient safety and clinical effectiveness outcomes including mortality, physical symptoms, length of stay and adherence to treatment. Results: This study, summarising evidence from 55 studies, indicates consistent positive associations between patient experience, patient safety and clinical effectiveness for a wide range of disease areas, settings, outcome measures and study designs. It demonstrates positive associations between patient experience and self-rated and objectively measured health outcomes; adherence to recommended clinical practice and medication; preventive care (such as health-promoting behaviour, use of screening services and immunisation); and resource use (such as hospitalisation, length of stay and primary-care visits). There is some evidence of positive associations between patient experience and measures of the technical quality of care and adverse events. Overall, it was more common to find positive associations between patient experience and patient safety and clinical effectiveness than no associations. Conclusions The data presented display that patient experience is positively associated with clinical effectiveness and patient safety, and support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare. It supports the argument that the three dimensions of quality should be looked at as a group and not in isolation. Clinicians should resist sidelining patient experience as too subjective or mood-oriented, divorced from the ‘real’ clinical work of measuring safety and effectiveness.

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Refund Policy

Rental orders with HealthHub Patient Engagement Solutions are refundable within the following guidelines:

  • Days that have been paid for (paid days1 ), but cannot be used due to a service interruption3 caused by a qualified technical issue4 may be refunded at the daily rate.

  • A day is considered used 2 hours after rental start time. Rental start time is defined by the rental order.

  • Any free days2 of rental included in a multi-day rental package cannot be exchanged for money or transferred to another patient.

  • If a refund is processed before all paid days are used, any free days are forfeited.

  • Refunds are processed from the time they are requested, and will not be backdated.

  • Once a service interruption is reported, paid days will be either refunded or added to the rental period (the choice is up to the patient). Free days will be added to the rental period, and cannot be refunded or exchanged for money.

Definitions

1 Paid days = Days of service paid for with your chosen service package. All paid days must be used before the free days in a package begin. There is 1 paid day in the daily package, 5 paid days in the weekly package and 15 paid days in the monthly package. (Please note: some sites may have different rental packages).

2 Free days = Days of service that were gifted to you by HealthHub with your chosen service package. The weekly package includes 2 free days (5 paid days, 2 free days) the monthly includes 15 free days (15 paid days, 15 free days). (Please note: some sites may have different rental packages).

3 Service interruption = Service use disrupted due to a qualified technical issue, or due to being moved to a new room with a missing or damaged HealthHub terminal. (Please note: this policy applies to service delivery problems for which HealthHub is responsible; it does not apply to those for which the hospital is responsible).

4 Qualified technical issue = A technical problem that impacts service delivery or enjoyment of services on your device.

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