{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:02:30Z","timestamp":1784512950301,"version":"3.55.0"},"reference-count":25,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sinai UHN Medical Organization","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000037","name":"Institute of Health Services and Policy Research","doi-asserted-by":"publisher","award":["PJM 185770"],"award-info":[{"award-number":["PJM 185770"]}],"id":[{"id":"10.13039\/501100000037","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000037","name":"Institute of Health Services and Policy Research","doi-asserted-by":"publisher","award":["PJM 192150"],"award-info":[{"award-number":["PJM 192150"]}],"id":[{"id":"10.13039\/501100000037","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000241","name":"Physicians\u2019 Services Incorporated Foundation","doi-asserted-by":"publisher","award":["F2-204"],"award-info":[{"award-number":["F2-204"]}],"id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]},{"name":"St Michael\u2019s Hospital Academic Medical Organization","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2026,6,15]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Quality improvement efforts on general medical wards are often driven by organisational or clinician priorities, and little is known about patient or caregiver priorities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To understand contributors to patients\u2019 in-hospital experience and how patients and caregivers prioritise these for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited inpatients or their caregivers from the general medical wards of 10 hospitals across Canada from November 2023 to February 2025 to participate in a group concept mapping study. Group concept mapping is a participatory multistep mixed method used to understand how a group views a particular topic. We used a targeted recruitment strategy to ensure inclusion of individuals who identified as non-white, preferred a non-English language, were unhoused, had a history of a mental health condition or who had dementia. An open-ended prompt elicited narratives about the inpatient experience. These were iteratively summarised into statements, which subsequent participants thematically sorted and rated in response to two rating questions: (1) extent of negative impact on well-being and (2) prioritisation for quality improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>302 participants (230 patients, 72 caregivers) responded to the open-ended prompt. These were synthesised into 935 ideas, summarised into 42 unique statements, which were then rated (N=203 participants) and sorted (N=50), generating a concept map with six clusters: Environment &amp; Facilities, Personal Support, Delays, Communication, Nutrition, Inclusivity &amp; Engagement. There was no correlation between rating results for impact to well-being versus prioritisation for quality improvement. The \u2018Delays\u2019, \u2018Communication\u2019 and \u2018Inclusivity &amp; Engagement\u2019 conceptual clusters contained many of the highest-rated improvement priorities. Prioritisation was consistent across participant subgroups, despite variation in how these groups rated items on impact to well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides a ranked list of priorities, setting an agenda that is grounded in the patient experience. Overall, patients\u2019 and caregivers\u2019 own negative inpatient experiences had little bearing on overall prioritisation for quality improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjqs-2026-020280","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T01:35:14Z","timestamp":1784511314000},"page":"bmjqs-2026-020280","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Patient and caregiver priorities for quality improvement on general medical wards: a multicentre group concept mapping study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-6719","authenticated-orcid":false,"given":"Lauren","family":"Lapointe-Shaw","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University Health Network and Sinai Health System, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"},{"name":"Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Salahub","sequence":"additional","affiliation":[{"name":"Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minkyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6857-931X","authenticated-orcid":false,"given":"Amol A.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Razak","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshula","family":"Ambasta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Department of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7315-2836","authenticated-orcid":false,"given":"Mohammad","family":"Refaei","sequence":"additional","affiliation":[{"name":"Hematology and Thromboembolism, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada"},{"name":"Oncology (Hematology & Thrombosis), Niagara Health System, St. Catharines, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"},{"name":"Department of Medicine, St. Joseph's Health Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Moses","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabha","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley P.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Spicer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-1193","authenticated-orcid":false,"given":"Shail","family":"Rawal","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University Health Network and Sinai Health System, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Soong","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University Health Network and Sinai Health System, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Kuluski","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0754-1830","authenticated-orcid":false,"given":"Karen","family":"Okrainec","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University Health Network and Sinai Health System, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"},{"name":"Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-7114","authenticated-orcid":false,"given":"G. 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