The wordpatient originally meant 'one who suffers'. This English noun comes from theLatin wordpatiens, thepresent participle of thedeponent verb,patior, meaning'I am suffering', and akin to theGreek verbπάσχειν (paskhein'to suffer') and its cognate nounπάθος (pathos).
This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging inshared decision-making about their care.[1]
Anoutpatient (orout-patient) is a patient who attends anoutpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still registered, and the provider will usually give a note explaining the reason for thevisit,tests, orprocedure/surgery, which should include the names and titles of the participating personnel, the patient's name anddate of birth, signature ofinformed consent, estimated pre-and post-service time forhistory andexam (before and after), anyanesthesia,medications or futuretreatment plans needed, and estimated time ofdischarge absent any (further)complications. Treatment provided in this fashion is calledambulatory care. Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is calledoutpatient surgery or day surgery, which has many benefits including loweredhealthcare cost, reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limitedurinary-tract,eye, orear, nose, and throat procedures and procedures involving superficial skin and the extremities). More procedures are being performed in asurgeon's office, termedoffice-based surgery, rather than in a hospital-basedoperating room.
A mother spends days sitting with her son, a hospital patient in Mali
Aninpatient (orin-patient), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as withcoma orpersistent vegetative state, patients can stay in hospitals for years, sometimes untildeath. Treatment provided in this fashion is calledinpatient care. The admission to the hospital involves the production of anadmission note. The leaving of the hospital is officially termeddischarge, and involves a correspondingdischarge note, and sometimes an assessment process to consider ongoing needs. In theEnglish National Health Service this may take the form of "Discharge to Assess" - where the assessment takes place after the patient has gone home.[2]
Misdiagnosis is the leading cause ofmedical error in outpatient facilities. When the U.S.Institute of Medicine's groundbreaking 1999 report,To Err Is Human, found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year,[3] early efforts focused on inpatient safety.[4] While patient safety efforts have focused on inpatient hospital settings for more than a decade, medical errors are even more likely to happen in adoctor's office or outpatient clinic or center.[citation needed]
Aday patient (orday-patient) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used bypsychiatric hospital services using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However, the term is now also heavily used for people attending hospitals for day surgery.
Because of concerns such asdignity,human rights andpolitical correctness, the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used includehealth consumer,healthcare consumer,customer orclient. However, such terminology may be offensive to those receivingpublic health care, as it implies a business relationship.
Thedoctor–patient relationship has sometimes been characterized as silencing the voice of patients.[6] It is now widely agreed that putting patients at the centre of healthcare[7] by trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction.[8]
When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible.[9] Incidents, such as theStafford Hospital scandal,Winterbourne View hospital abuse scandal and theVeterans Health Administration controversy of 2014 have shown the dangers of prioritizing cost control over the patient experience.[10] Investigations into these and other scandals have recommended that healthcare systems put patient experience at the center, and especially that patients themselves are heard loud and clear within health services.[11]
There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct.[12] Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect',[9] that are difficult to capture with institutional monitoring.[13]
One important way in which patients can be placed at the centre of healthcare is for health services to be more open about patient complaints.[14] 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 about and improve patient experience.[15]
^Frampton, Susan B.; Guastello, Sara; Hoy, Libby; Naylor, Mary; Sheridan, Sue; Johnston-Fleece, Michelle (31 January 2017). "Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care".NAM Perspectives.7 (1).doi:10.31478/201701f.
^Levtzion-Korach, O; Frankel, A; Alcalai, H; Keohane, C; Orav, J; Graydon-Baker, E; Barnes, J; Gordon, K; Puopulo, AL; Tomov, EI; Sato, L; Bates, DW (September 2010). "Integrating Incident Data From Five Reporting Systems to Assess Patient Safety: Making Sense of the Elephant".Jt Comm J Qual Patient Saf.36 (9):402–10.doi:10.1016/s1553-7250(10)36059-4.PMID20873673.
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