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Patients

An outpatient (or out-patient) is a patient who is hospitalized for less than 24 hours. Even if the patient will not be formally admitted with a note as an outpatient, they are still registered, and the provider will usually give a note explaining the reason for the service, procedure, scan, or surgery, which should include the names and titles and IDs of the participating personnel, the patient’s name and date of birth and ID and signature of informed consent, estimated pre- and post-service time for a history and exam (before and after), any anesthesia or medications needed, and estimated time of discharge absent any (further) complications. Treatment provided in this fashion is called ambulatory care. Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay.

The doctor-patient relationship has sometimes been characterized as silencing the voice of patients. It is now widely agreed that putting patients at the centre of healthcare, by trying to provide a consistent, informative and respectful service to patients, will improve both outcomes and patient satisfaction.

When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible. Scandals in the UK, such as the Stafford Hospital scandal and the Winterbourne View hospital abuse scandal, have shown the dangers of silencing the voice of patients. Investigations into these, and similar scandals, have recommended that the health service put patient experience at the heart of what it does, and especially, that the voice of patients is heard loud and clear within the health services.

There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than any regulators or quality controllers. Patients can recognize problems such as service delays, poor hygiene, and poor conduct. Patients are particularly good at identifying soft problems, such as attitudes, communication, and ‘caring neglect’, that are difficult to capture with institutional monitoring.

One important way in which patients can be put at the centre of healthcare is for health services to be more open about patient complaints. Each year many hundreds of thousands of patients complain about the care they have received, and these complaints contain valuable information for any health services which want to learn and improve patient experience.

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