Understanding what matters most to patients in acute care in seven countries, using the flash mob study design
Authors: van den Ende Eva S. , Schouten Bo , Kremers Marjolein N. T. , Cooksley Tim , Subbe Chris P. , Weichert Immo , van Galen Louise S. , Haak Harm R. , Kellett John , Alsma Jelmer , Siegrist Victoria , Holland Mark , Christensen Erika F. , Graham Colin A. , LEUNG Ling Yan , Laugesen Line E. , Merten Hanneke , Mir Fraz , Kidney Rachel M. , Brabrand Mikkel , Nanayakkara Prabath W. B. , Nickel Christian H. ,   on behalf of all local collaborators, Nielsen Vibe Maria Laden , Andersen Karen Vestergaard , Nygaard Hanne , Iversen Kasper Karmark , Schultz Martin , Hallas Peter , Kreiberg Magnus Peter Brammer , Laugesen Line Emilie , Green Anne Mette , Kristensen Tanja Mose , Skjøt-Arkil Helene , Gamst-Jensen Hejdi , Thomsen Torbjørn Shields , Nielsen Camilla Dahl , Jensen Kristian Møller , Hansen Søren Nygaard , Ludwig Marc , Høg Henriette Sloth , Bove Dorthe Gaby , Mikkelsen Vibe Kristine Sommer , Laugesen Sune , Todorovac Nerma , Nielsen Stine Nørris , Petersen Poul , Karstensen Hanna , Tygesen Gitte Boier , Aabling Rasmus , Pedersen Lone , Van Den Beuken Sef J. L. W. , Høgsgaard Ditte , Christophersen Thomas , Smedegaard Christina , Worsøe Mette , Bouchy Jacobsson Marie-Laure M. A. , Lyngholm Le Elias , Lindholm Sara Fonager , van Pelt-Sprangers J. M. , So Ralph K. L. , Anten Sander , van den Besselaar Judith , Buunk Gerba , Romano Lorenzo , Schattenkerk Daan Eeftick , Holleman Frits , Nannan Panday Rishi S. , Rowling Sacha C. , Schinkel Michiel , van Benthum Sophie , Logtenberg S. J. J. , Jacobs Esther M. G. , Alsma Jelmer , Boogers William , Verhoeff Marlies , van Munster Barbara V. , Gans Emma , Briët-Schipper Noortje , Raz Yotam , Lavell Ayesha , El Morabit Fatima , Timmers Gert-Jan , Dees Ad , Carels Ginette , Snijer Berit , Heitz Anne Floor , Keurlings Pim A. J. , Deenen Susan , Stassen Patricia M. , Kabboue Hajar , Schouten Ineke , Siegert C. E. H. , Hoogerwerf Jacobien J. , de Kleijn Lianne , Bosch Frank H. , Govers Annebel , van den Corput Bianca , Noordzij-Nooteboom H. S. , Dekkers M. J. , van den Berg Annemarie , ter Maaten Jan C. , Barten Dennis G. , Zaalberg Tessel , Soong John , Nashi Norshima , van Galen Louise S. , Tin Lim Wan , Balakrishnan Tharmmambal , Zainuddin Siti Khadijah Binte , Nickel Christian H. , Siegrist Victoria , Mir Fraz , Nadarajah Channa Vasanth , Lewis Aled , Ward David , Weerasekera C. , Soe Thandar , Cozens Thomas , McDonald Joanne , Holland Mark , Down Andrew , Weichert Immo , Altemimi Harith , Cooksley Tim , Seccombe A. , Subbe Chris P. , Lovell Ben , Graham Colin , Lo Ronson , Leung Ling , Kidney Rachel M. 
Published: May 2021

Abstract
Background
Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this.

Methods
This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this.

Results
The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them.

Conclusions
The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care.

Trial registration
NTR (Netherlands Trial Register) NTR7538.