Measuring health outcomes, experience of care and cost of healthcare in student-led healthcare services: A literature review
Keywords:student-led healthcare service, Triple Aim, population health, patient experience, cost of care, evaluation, quality improvement
Introduction: In student-led healthcare services, health students take responsibility for the management and delivery of health services as part of clinical training. Like all healthcare services, student-led healthcare services need to be evaluated to ensure they provide high quality, safe and cost-effective services. The aim of this literature review was to understand how student-led healthcare services have been evaluated to date and to assess alignment of previous evaluations with the Triple Aim framework. The Triple Aim is a conceptual framework offering a systematic approach to evaluating healthcare services that may be appropriate for evaluation of student-led services.
Methods: Electronic databases were searched for articles describing a student-led healthcare service and were screened for studies that evaluated the impact of a student-led healthcare service on patient outcomes. Critical appraisal was informed by Stiefel and Nolan’s (2012) IHI white paper A Guide to Measuring the “Triple Aim”, and each article was appraised against the Triple Aim measurement principles and dimensions of care.
Results: Fourteen of 211 identified articles met the inclusion criteria. All 14 studies met the Triple Aim measurement principles of “a defined population”, “gather data over time” and “distinguish between measures”, while only eight of the 14 studies achieved “comparison data”. All 14 studies measured at least one or more of the Triple Aim dimensions.
Conclusions: There was little consistency across the evaluations of student-led healthcare services, limiting the extent to which the benefits of student-led healthcare services can be shown to be a valuable resource to the healthcare system. Further investigation is required to determine a suitable evaluation framework for student-led healthcare services.
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