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Background Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly acknowledged as critical tools for enhancing patient-centred, value-based care. However, research is lacking on the impact of using standardized patient-reported indicators in acute psychiatric care. The aim of this study was to explore whether subjective well-being indicators (generic PROMs) are relevant for evaluating the quality of hospital care, distinct from measures of symptom improvement (disease-specific PROMs) and from PREMs. Methods Two hundred and forty-eight inpatients admitted to a psychiatric university hospital were included in the study between January and June 2021. Subjective well-being was assessed using standardized generic PROMs on well-being, symptom improvement was assessed using standardized disease-specific PROMs, and experience of care using PREMs. PROMs were completed at admission and discharge, PREMs were completed at discharge. Clinicians rated their experience of providing treatment using adapted PREMs items. Results Change in subjective well-being (PROMs) at discharge was significantly (p < 0.001), but moderately (r2 = 28.5%), correlated to improvement in symptom outcomes, and weakly correlated to experience of care (PREMs) (r2 = 11.0%), the latter being weakly explained by symptom changes (r2 = 6.9%). Patients and clinicians assessed the experience of care differently. Conclusions This study supports the case for routinely measuring patients’ subjective well-being to better capture the unmet needs of patients undergoing psychiatric hospital treatment, and the use of standardized patient-reported measures as key indicators of high quality of care across mental health services.

Heute werden mehr Menschen in Langzeitpflegeeinrichtungen versorgt als je zuvor, darunter immer mehr Personen mit chronischen Krankheiten und Mehrfacherkrankungen. Diese Entwicklung durfte sich in Anbetracht der zunehmenden Bevolkerungsalterung im OECD-Raum fortsetzen. Die Kosten vermeidbarer Krankenhauseinweisungen aus Langzeitpflegeeinrichtungen beliefen sich 2016 auf knapp 18 Mrd. USD. Dies entspricht 2,5 % der Ausgaben fur die stationare Krankenhausversorgung bzw. 4,4 % der Ausgaben fur die Langzeitpflege. Forschungsarbeiten zeigen, dass mehr als die Halfte der unerwunschten Ereignisse in der Pflege und 40 % der Krankenhauseinweisungen aus Pflegeeinrichtungen vermeidbar sind. Den Grundursachen dieser Ereignisse kann durch bessere Pravention, Sicherheitsmasnahmen und Personalentwicklung – insbesondere im Hinblick auf den Kompetenzmix und die Ausbildung – begegnet werden. Durch gezielte Investitionen in Schlusselbereichen konnen signifikante Effekte erzielt und die wichtigsten Kostentreiber unerwunschter Ereignisse in der Langzeitpflege reduziert werden.

Health care settings are inherently hazardous places, with very unpredictable and complex working environments. These hazards and risks not only result in a range of injuries and ill-health among workers but also jeopardise the safety of patients. The COVID-19 crisis has amplified the importance of ensuring that the health care that is provided is safe—for patients and health workers alike. A sufficient, and capable, workforce, is the foundation of resilient systems. Policy makers need to focus now on how to build and support an appropriate workforce to respond to future shocks. This includes health workers beyond the hospital—including those in community, long-term, and primary care. The safety of both patients and health workers should be protected through appropriate mechanisms to ensure the safety of protective equipment and sufficient supplies, appropriate staffing levels, training and support at the workplace. These governance mechanisms are even more relevant when policy makers face trade-offs between health, safety and economic concerns.

Long-term care (LTC) institutions are now providing care to a greater number of people, and more residents with chronic conditions and multiple co-morbidities, than ever before. Trends suggest this strain will continue to increase as OECD populations continue to age. The total cost of avoidable admissions to hospitals from LTC facilities in 2016 was almost USD 18 Billion, equivalent to 2.5% of all spending on hospital inpatient care or 4.4% of all spending on LTC. Research shows that over half of the harm that occurs in LTC is preventable, and over 40% of admissions to hospitals from LTC are avoidable. The root causes of these events can be addressed through improved prevention and safety practices and workforce development—including skill-mix and education. Targeted investments in a number of key areas can have a significant impact by mitigating the main cost drivers of adverse events in LTC.

While health care quality has been improving on average in OECD members countries, patient safety remains a central priority for policy makers and health care leaders. A growing research body has found that PSC is associated with numerous positive outcomes, including improved health outcomes, improved patient experience, and organisational productivity and staff satisfaction. Tools to measure PSC have proliferated in recent decades and are now in wide-spread use. This report includes findings from OECD countries on the state of the art for measurement practices related to PSC. Overall, measurement of PSC is prevalent across OECD countries, though the application, purpose, and tools vary. International learning and benchmarking has significant potential for better understanding and improvement of patient safety and health care quality.