Early lessons from four 'aligning forces for quality' communities bolster the case for patient-centered care.

The practice of patient-centered care remains in its developmental stages-hampered, in part, by limited evidence of its effectiveness. In this article we first review available evidence on patient-centered care, such as the positive effects of engaging patients in quality improvement activities. We also point out the existence of a research gap that makes it difficult to quantify the effect of "culture change" in health care, and to attribute improvements specifically to patients' involvement. We then discuss the benefits of involving consumers in the design and improvement of products and services outside the health care industry, and we present early lessons on engaging patients to improve ambulatory care in four communities--Humboldt County, California; south central Pennsylvania; Maine; and Oregon--participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality initiative. These lessons, although early, illustrate that actively engaging patients in improving ambulatory care improves provider-patient communication, identifies and avoids potential challenges to new services, and improves provider and patient satisfaction.