Rethinking Healthcare Performance Evaluation Systems towards the People- Centredness Approach: Their Pathways, their Experience, their Evaluation.

Patient experience should be the starting point to achieve a high quality care. Coherently, healthcare performance evaluation systems, driving the change in line with the main strategic goals, should be designed considering the patient perspective. Instead, they are traditionally de ned according to the healthcare service providers’ point of view. Consequently, they reproduce a “silo-vision” characterized by a clear responsibilities separation and limited to a speci c setting of care or to a single organi- zation. This commentary discusses the importance of using patient-reported meas- ures together with indicators based on administrative data to evaluate cross-setting healthcare services within a multidimensional healthcare performance evaluation system. The experience of the Tuscany regional healthcare Performance Measurement System (PMS), implemented more than 10 years ago and revised lately, represents an innovative example of how to measure the quality of the whole care pathway includ- ing patient experience. This new approach is based on a systematic, systemic and standardized collection of patient-reported experience measures in several healthcare pathways and evaluating them using a coherent graphical representation. Targets, incentives and other managerial tools are xed overcoming organizational bounda- ries and integrating the patient point of view with the goal of moving the healthcare system towards a patient-centredness approach to care.