TY - JOUR T1 - Patient-centred care: confessions of a pragmatist JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 909 LP - 910 DO - 10.1136/bmjqs-2015-005035 VL - 25 IS - 12 AU - Kenneth EF Sands Y1 - 2016/12/01 UR - http://qualitysafety.bmj.com/content/25/12/909.abstract N2 - The essential importance of patient-centredness is no longer in dispute. More than 15 years ago, the Institute of Medicine incorporated patient-centred care as elemental to the definition of quality care.1 In his 2009 ‘Confessions of an Extremist’ essay, Sir Donald Berwick goes further, arguing that patient-centredness is ‘not a route to the point; it is the point’.2 At the same time, we all recognise that our current systems do not optimise patient centredness. At our institution, we have begun tracking episodes of ‘disrespect’ with the same systems we use to track patient safety events, and are learning that these emotional harms are more common than the physical harms we have tracked so rigorously for many years.3 The case has been made and the challenge accepted: we need to reconfigure care delivery to be more patient-centred.The challenge now is how best to achieve that reconfiguration, using evidence-based interventions. Yes, there is a solid literature that demonstrates patient-centred care interventions improve clinical outcomes,4 but there remains a yawning knowledge gap regarding what works to improve patient centredness within … ER -