Patient-Derived Framework for Quality in Hand Surgery: A Qualitative Analysis.

Area of Science:

• Medical quality assessment
• Patient-centered care
• Hand surgery outcomes

Background:

• Current quality measures in healthcare are often physician-defined, potentially misaligning with patient priorities.
• Discrepancies in quality assessment between patients and physicians can negatively impact patient outcomes.
• Existing quality measures in hand surgery lack sufficient examination of patient perspectives.

Purpose of the Study:

• To explore how patients define high-quality care in hand surgery.
• To identify patient-centered themes across pre-, peri-, and postoperative phases of hand surgery.
• To bridge the gap between health system quality metrics and patient-valued care aspects.

Main Methods:

• Conducted semistructured interviews with 43 hand surgery patients across 5 tertiary-care institutions.
• Utilized an open-ended interview guide based on prior research.
• Performed thematic analysis to identify patient-defined themes of high-quality care.

Main Results:

• Patients perceive high-quality care as meeting expectations, achieving functional goals, and feeling supported by the care team.
• Key patient-centered themes include effective communication, accurate diagnosis/treatment, satisfactory outcomes, and acceptable systemic care.
• Four core themes emerged: communication, efficient diagnosis/treatment, satisfactory outcomes, and systemic care aspects.

Conclusions:

• Healthcare improvement initiatives must integrate patient-important aspects of care.
• Measuring often-overlooked elements like communication can enhance care quality from the patient's viewpoint.
• Findings can guide the development of patient-centered quality measures in hand surgery.