Patient centredness and quality improvement efforts in hospitals: rationale, measurement, implementation.

QUALITY PROBLEM: Patient-centred care is increasingly being acknowledged as an integral part of evaluating health care. Yet, from a quality improvement perspective the rationale, measurement and implementation of strategies to improve patient-centred care is often subject to debate. OBJECTIVE: The aim of this paper is to review why quality improvement efforts should embrace patient-centredness, to examine some of the measurement issues and to assess conceptual underpinnings that should inform both measurement and actions to improve patient-centred care. LESSONS: The causal pathway through which quality improvement affects and/or is associated with patient centredness is complex and goes beyond patients' rights and assessing patient views. Interventions to improve patient-centred care should reflect on key rationale, measurement strategy and underlying theory.