Importance of a Value-Based Health Care in a Neurosurgery Service: Prems and Proms

Background: There is not always a direct correlation between surgical intervention and a greater patient well-being. The concepts of PROMs (Patient Reported Outcomes Measures) and PREMS (Patient Reported Experience Measures) arose to determine those health care factors that have an impact on the quality of life and patient experience. With the aim of improving the patient experience, the Neurosurgery Service of the University Hospital of Navarra has developed a project based on Value-based health care, taking into account the concepts of PROMs and PREMS, together with two external consultors.

Methods: The project is based on 8 days of field research performed by 2 senior consultants. During this time, the 2 consultants lived with the health professionals and conducted in-depth interviews (duration between 20 and 60 minutes) with 30 patients and companions. The interviews were based on open questions, allowing the patient and the companions to present their experience in as much detail as possible. In addition to the interviews, Safaris (nonparticipant and participant observations) were performed in various locations (waiting rooms, admission, hospital ward...).

Results: A Patient Journey Map has been prepared, which includes the main interactions that patients and companions have with the Neurosurgery Service, as well as lines of action around 6 key areas: empowerment or training, understanding, well-being, confidence, availability or accessibility and tact and treatment.

Conclusions: The patient's experience is closely associated with the expectations of quality of life after the intervention. For all these reasons, it is necessary to attend to other aspects in addition to the purely technical ones to improve the patient's experience throughout the entire process.

Publication History

Article published online:
05 February 2024