Last week the King’s Fund ran an interesting day on
improving the experience of patients in hospital, as part of its Point of Care
programme. Lots of good people with plenty of expertise and good ideas.
But one thing struck me quite hard: whenever people start
talking about “listening to the patient experience”, the question of
measurement comes up – and sometimes takes over. Often, there seems to be an
implicit assumption that just by measuring something, we’ll create change. So let’s
measure the patient experience!
I’ve got nothing against measuring things (when I had a
career, it was as a quantitative health services researcher). But we’ve got to
gain some clarity over what measuring is for.
Measuring is fundamentally about the past. How are things
now? How were they last week? Did we improve? But nothing about measuring
changes the future in any radical way. If anything, measuring reinforces a
future which is similar to the past, only “a bit better”.
More than that, I’d argue that measuring is an act of
power, and being measured is an act of powerlessness. By measuring “the patient
experience” we reinforce, rather than question, the patient’s status as object,
rather than subject. Nobody with real power gets measured.
The rhetoric of understanding “the patient experience” is
about listening – but the implementation is about measuring. At the event, I
asked whether there was a conflict between listening and measuring. Now I think
there is.
To me, listening is an act of compassion which recognises
a common humanity and, I believe, holds the potential to create radically
different futures. Measuring won’t change the world: it will only tell you
whether the world changed.
Unless you think differently?