Evidence map›Paper›PMID 42656025›Full record

ArticleThe Permanente journal2026

Timeliness, Coordination, Clarity, and Kindness: Patients' Interpretations of Provider Actions as Indicators of Quality Cancer Care.

Lily N Shapiro, Kimberly C Arthur, Laurel D Hansell, Susan Brandzel, Jessica Chubak, Larissa L White, Morgan Clennin, Caryn Oshiro, Stacey A Honda, Tatjana Kolevska and 2 more

Abstract read
In one paragraph

Article in The Permanente journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lily N ShapiroKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.ORCID 0000-0002-3285-3572
Kimberly C ArthurKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Laurel D HansellKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Susan BrandzelKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.ORCID 0000-0002-9880-3797
Jessica ChubakKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Larissa L WhiteInstitute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.ORCID 0000-0001-9364-2704
Morgan ClenninInstitute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
Caryn OshiroCenter for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, HI, USA.
Stacey A HondaCenter for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, HI, USA.
Tatjana KolevskaKaiser Permanente Medical Center, Vallejo, CA, USA.
Mishellene McKinneyKaiser Foundation Health Plan and Hospitals, Oakland, CA, USA.
Marlaine Figueroa GrayDepartment of Anthropology, University of Washington, Seattle, WA, USA.ORCID 0000-0003-1425-3968

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatient-reported measures are important tools in assessing cancer care quality, yet they may overlook the interpretive work patients do in making sense of provider and health system actions. Beyond practical aspects, patients read specific actions symbolically, as signals of respect, competence, and concern. This study explored how individuals diagnosed with cancer understand and define high- and low-quality care.

methodsThe authors have conducted semistructured interviews with 58 adults diagnosed with cancer within the previous year across 3 regions of an integrated health system. Interviews were analyzed using thematic coding.

resultsParticipants consistently framed their experiences through interpretations of specific provider and system actions. Three primary domains emerged: timeliness and responsiveness, proactive coordination and advocacy, and clarity, with kindness identified as a meta theme. Actions including rapid callbacks, proactive scheduling, and clear explanations were understood as both operational efficiencies and evidence that providers were trustworthy and cared about patients. Conversely, delays, poor communication, and lack of coordination were interpreted as indifference or lack of urgency. DISCUSSION: The findings of the authors have underscored that patients interpret care actions through both practical and symbolic lenses. Even when clinical outcomes are favorable, perceived indifference or unclear communication can erode trust and heighten distress. These insights expand quality frameworks by highlighting relational and interpretive dimensions of care.

conclusionTimeliness, coordination, clarity, and kindness are not merely operational goals but signals of empathy and respect that profoundly shape patient experience. Integrating these dimensions into quality improvement efforts can advance cancer care that is clinically effective and responsive to human needs.

Indexed as

NeoplasmsQuality Indicators, Health CareQuality of Health CareAdultAgedCommunicationFemaleHumansInterviews as TopicMaleMiddle AgedPatient Reported Outcome MeasuresPhysician-Patient RelationsQualitative ResearchTime Factors

Identifiers

PMID42656025
PMCPMC13576030

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.