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Literature review on the evaluation of the quality of care from a patient’s perspective


Intern for CRASH (June - August 2018), currently studying at George Washington University (US).

The study The Patient Perspective of Quality of Care: A Review of the Literaturewhich we present here was carried out by Hannah BarnettA public health student at George Washington University, intern with CRASH from June to August 2018.. This work sums up seventy articles from a variety of disciplines including medicine and public health. It is part of a reflection initiated by MSF a few years ago on medical quality and the patient-centered approachThe CRASH Handbook Disabilities and Medicine. A survey of the Amman surgical reconstruction project 2012, published in 2013, focuses on the concept of dependence during long-term care at the Amman Hospital in Jordan, considering the perspectives of MSF staff and patients. In 2016, a workshop was held at MSF-France on the quality of care and more specifically about the standards and management of care, following which was published in 2017 the CRASH Handbook: Médecins Sans Frontières and medical quality. For a year and a half, anthropologist Vanja Kovacic has been studying, again at Amman Hospital, the patient / caregiver relationship with regard to the quality of life of the patients. In the field, MSF has also gained important experience in transferring responsibility to the patients in HIV and TB projects..

As Jean-Hervé Bradol explained to members of the operations and medical departments during a meeting where the review was discussed:

"Generally speaking, we can consider that our way of delivering care is "out-dated" because it was built on different epidemiological situations and policies from what we experience nowadays. When I started working at MSF, we mainly treated diseases like malaria, diarrhea and not chronical diseases. The diseases we treat today are more diverse. For instance, we are getting started to pay interest in oncology. Therefore it makes sense to look for new models of health care. However, it seems important to me not to consider the patient-centered approach as a sort of empty catchword. We have to conceive how to concretely optimize the quality of care considering specific difficulties such as sharing medical information, case management..."

This desire to see medical care evolving within MSF can lead us to clarify, on the one hand, what we want to do when we argue in favor of a patient-centered approach (educating patients or better integrating them and giving them more responsibility? In which projects? For what pathologies?...) and secondly, how we want to do it (what support shall we bring in the field to improve the patient / caregiver relationship and how to make the patient's voice heard? What tools could MSF use to gather the patient experience?)

To cite this content :
Hannah BARNETT, “Literature review on the evaluation of the quality of care from a patient’s perspective”, 15 février 2019, URL :

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