Instrument

Picker Institute

The Picker inpatient surveys distinguish eight dimensions of patient-centered care: Access (including time spent waiting for admission or time between admission and allocation to a bed in a ward); Respect for patient's values, preferences, and expressed needs (including impact of illness and treatment on quality of life, involvement in decision making, dignity, needs and autonomy); Coordination and integration of care (including clinical care, ancillary and support services, and "front-line" care); Information, communication, and education (including clinical status, progress and prognosis, facilitation of autonomy, self-care and health promotion); Physical comfort (including pain management, help with activities of daily living, surroundings and hospital environment); Emotional support and alleviation of fear and anxiety (including treatment and prognosis, impact of illness on self and family, financial impact of illness); Involvement of family and friends (including social and emotional support, involvement in decision making, impact on family dynamics and functioning); Transition and continuity (including information about medication and danger signs to look out for after leaving the hospital, coordination and discharge planning, clinical, social, physical and financial support).

Hospital-Patient Relations; Hospitals; Patient Satisfaction; Psychometrics; Quality of Health Care; Questionnaires; Reproducibility of Results

Picker Surveys are internationally available.

Researchers at the Picker Institute had suspected, and later confirmed through extensive research, that simply adopting the accepted measurement tools in place then, and even today, would not in fact assist hospitals in improving patient experience and outcome. They theorized that current patient experience tools and programs too often approached the task from an institutional mindset and failed to collect data most relevant to patients. Thus, the Picker Institute pioneered the use of carefully designed instruments to obtain detailed reports of patient's experience. Instead of asking patients to provide simple satisfaction ratings, as had been standard practice for measuring care, the Picker surveys asked patients whether or not certain processes and events occurred during the course of a specific episode of care. Following extensive research to find out what patients thought about the way they were treated and what the problems were from their point of view, questionnaires were designed to focus on specific dimensions of patients' experience. These questionnaires have been used since 1987 in hospitals in the US and Canada, since 1994 in the UK, and since 1997 in Germany, Sweden and Switzerland.

Sheps Center, UNC-CH

The questionnaire is designed to be analyzed by creating 40 dichotomous "problem scores" indicating the presence or absence of a problem. These can be summed into "dimension scores" representing the groupings listed above. In addition, some "rating" questions are included to assess patients' overall experience.

Access; Respect for patient's values, preferences, and expressed needs; Coordination and integration of care; Information, communication, and education; Physical comfort; Emotional support and alleviation of fear and anxiety; Involvement of family and friends; Transition and continuity

Since 1987

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