TY - JOUR T1 - What are patients’ care experience priorities? JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 356 LP - 359 DO - 10.1136/bmjqs-2015-004298 VL - 24 IS - 6 AU - Rick A Iedema AU - Blake Angell Y1 - 2015/06/01 UR - http://qualitysafety.bmj.com/content/24/6/356.abstract N2 - We are investing considerable resources in defining and measuring patients’ care expectations. Such measurement will yield insight into whether and how services are meeting patients’ experience expectations. But because measurement is inherently distanced in time and space, it does not resolve patients’ experience of feeling ‘reluctant to directly challenge healthcare professionals’1 about issues that matter to them now and which may make them feel unsafe.Research has shown that when patients and family members experience concerns about their care, they want to be able to discuss these experiences with their clinicians. They often want such discussions to include explanations from professionals and dialogue about ‘what happened’ and about tensions, uncertainties and contradictions.2Patients and family members interviewed for a large incident disclosure study reported that they appreciated that care is complex,3 and that there may be no simple answers to explain care problems.4 But being granted the time for dialogue with their clinicians and service representatives reassured patients and family members that their concerns and questions were taken seriously. This meant for them in turn that similar events might be prevented from happening again. They also felt that dialogue reassured them that their views on and advice about how to improve care were respected. When patients have concerns about their care, the timing and authenticity of such dialogue are seen as paramount.For its part, measuring patients’ experiences presupposes abstracting ‘what happened to you’ into a general metric that applies to ‘people like you’. Measurement is, in the first instance, about the service and the system. Dialogue is about the patient and their family. Measurement will never obviate patients’ providing feedback about their concerns to their own clinicians and their local services.What started out as satisfaction surveying in the 1970s5 has now morphed into … ER -