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Oxenbøll Collet M, Albertsen H, Egerod I. Patient and family engagement in Danish intensive care units: A national survey. Nurs Crit Care 2024; 29:614-621. [PMID: 37402590 DOI: 10.1111/nicc.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/23/2023] [Accepted: 06/08/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Patient and family engagement in the intensive care unit increases the quality of care and patient safety. AIM The aim of our study was to describe current practice and experiences of contemporary patient and family engagement in the intensive care unit at the individual level, the organizational level, and in the research process according to critical care nurses. DESIGN/METHOD We conducted a national qualitative survey of intensive care units in Denmark from 5th May-5th June 2021. Questionnaires were piloted and sent to intensive care nurse specialists and research nurses at 41 intensive care units, allowing one respondent per unit. All respondents were provided with written information about the study by email, and by activating the survey link, they accepted participation. RESULTS Thirty-two nurses responded to the invitation, 24 completed and 8 partially completed the survey, yielding a response rate of 78%. At the individual level, 27 respondents stated that they involved patients and 25 said they involved family in daily treatment and care. At the organizational level, 28 intensive care units had an overall strategy or guideline for patient and family engagement, and 4 units had established a PFE panel. And, finally, 11 units engaged patients and families in the research process. CONCLUSIONS Our survey suggested that patient and family engagement was implemented to some degree at the individual level, organizational level, and in the research process, but only 4 units had established a PFE panel at the organizational level, which is key to engagement. RELEVANCE TO CLINICAL PRACTICE Patient engagement increases when patients are more awake, and family engagement increases when patients are unable to participate. Engagement increases when patient and family engagement panels are implemented.
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Affiliation(s)
- Marie Oxenbøll Collet
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Helle Albertsen
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Ingrid Egerod
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Lim ELP, Ong RHS, Thor J, Allgurin M, Gäre BA, Thumboo J. An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes. Int J Integr Care 2023; 23:11. [PMID: 38020415 PMCID: PMC10668878 DOI: 10.5334/ijic.7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners' PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of "caring about the service user as a whole person" and the "sharing of power, control and information". Methods A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points - before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time. Results A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to "care" than to "share power" with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3). Conclusion Training as a specific intervention, appeared to have potential to increase health practitioners' person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.
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Affiliation(s)
- Esther Li Ping Lim
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Allied Health Division, Singapore General Hospital, Singapore
- Centre for Person-centred Care, Singapore Health Services, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore
| | | | - Johan Thor
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Monika Allgurin
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Boel Andersson Gäre
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Futurum, Region Jönköping County, Jönköping, Sweden
| | - Julian Thumboo
- SingHealth Office of Regional Health, Singapore Health Services, Singapore
- SingHealth Centre for Population Health Research and Implementation, Singapore Health Services, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
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Sagnol G, Haesebaert J, Termoz A, Michel P, Schott AM, Potinet V, Pomey MP, Tazarourte K, Douplat M. Assessing patient partnership among emergency departments in France: a cross-sectional study. BMC Health Serv Res 2023; 23:897. [PMID: 37612727 PMCID: PMC10463322 DOI: 10.1186/s12913-023-09905-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES This study aims to describe the use of patient partnership, as defined by the Montreal Model, in emergency departments (EDs) in France and report the perception of patient partnership from both the practitioner and patient perspectives. METHODS This cross-sectional study was conducted between July 2020 and October 2020. First, a survey was sent to 146 heads of EDs in both teaching hospitals and non-teaching hospitals in France to assess the current practices in terms of patient partnership in service organization, research, and teaching. The perceived barriers and facilitators of the implementation of such an approach were also recorded. Then, semi-structured telephone interviews were carried out with patients involved in a service re-organization project. RESULTS A total of 48 answers (response rate 32.9%) to the survey were received; 33.3% of respondents involved patients in projects relating to service re-organization, 20.8% involved patients in teaching projects, and 4.2% in research projects. Overall, 60.4% of the respondents were willing to involve patients in re-organization or teaching projects. The main barriers mentioned for establishing patient partnership were difficulties regarding patient recruitment and lack of time. The main advantages mentioned were the improvement in patient/caregiver relationship and new ideas to improve healthcare. When interviewed, patients mentioned the desire to improve healthcare and the necessity to involve people with different profiles and backgrounds. A too important personal commitment was the most frequently raised barrier to their engagement. All the patients recognized their positive role, and more generally, the positive role of patient engagement in service re-organization. CONCLUSION Although this preliminary study indicates a rather positive perception of patient partnership among heads of EDs in France and partner patients, this approach is still not widely applied in practice.
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Affiliation(s)
- Geoffrey Sagnol
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Julie Haesebaert
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Anne Termoz
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
| | - Philipe Michel
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices civils de Lyon, Lyon, 69002 France
| | - Anne-Marie Schott
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Véronique Potinet
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Marie-Pascale Pomey
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC Canada
| | - Karim Tazarourte
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Edouard Herriot, 5 place d’Arsonval, Lyon, F-69003 France
| | - Marion Douplat
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- UMR 7268 ADéS, Aix-Marseille Université / EFS / CNRS, Espace éthique méditerranéen, Hôpital Adultes La Timone, 264 rue Saint Pierre, Marseille cedex 05, France
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Anderson NN, Baker GR, Moody L, Scane K, Urquhart R, Wodchis WP, Gagliardi AR. Consensus on how to optimise patient/family engagement in hospital planning and improvement: a Delphi survey. BMJ Open 2022; 12:e061271. [PMID: 36127114 PMCID: PMC9490572 DOI: 10.1136/bmjopen-2022-061271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Patient and family engagement (PE) in health service planning and improvement is widely advocated, yet little prior research offered guidance on how to optimise PE, particularly in hospitals. This study aimed to engage stakeholders in generating evidence-informed consensus on recommendations to optimise PE. DESIGN We transformed PE processes and resources from prior research into recommendations that populated an online Delphi survey. SETTING AND PARTICIPANTS Panellists included 58 persons with PE experience including: 22 patient/family advisors and 36 others (PE managers, clinicians, executives and researchers) in round 1 (100%) and 55 in round 2 (95%). OUTCOME MEASURES Ratings of importance on a seven-point Likert scale of 48 strategies organised in domains: engagement approaches, strategies to integrate diverse perspectives, facilitators, strategies to champion engagement and hospital capacity for engagement. RESULTS Of 50 recommendations, 80% or more of panellists prioritised 32 recommendations (27 in round 1, 5 in round 2) across 5 domains: 5 engagement approaches, 4 strategies to identify and integrate diverse patient/family advisor perspectives, 9 strategies to enable meaningful engagement, 9 strategies by which hospitals can champion PE and 5 elements of hospital capacity considered essential for supporting PE. There was high congruence in rating between patient/family advisors and healthcare professionals for all but six recommendations that were highly rated by patient/family advisors but not by others: capturing diverse perspectives, including a critical volume of advisors on committees/teams, prospectively monitoring PE, advocating for government funding of PE, including PE in healthcare worker job descriptions and sharing PE strategies across hospitals. CONCLUSIONS Decision-makers (eg, health system policy-makers, hospitals executives and managers) can use these recommendations as a framework by which to plan and operationalise PE, or evaluate and improve PE in their own settings. Ongoing research is needed to monitor the uptake and impact of these recommendations on PE policy and practice.
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Affiliation(s)
- Natalie N Anderson
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - G Ross Baker
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Moody
- Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Kerseri Scane
- Patient Partnerships, University Health Network, Toronto, Ontario, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Walter P Wodchis
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
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Teixeira CC, Bezerra ALQ, Paranaguá TTDB, Afonso TC. Professionals’ beliefs in patient involvement for hospital safety. Rev Bras Enferm 2022; 75:e20210359. [DOI: 10.1590/0034-7167-2021-0359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/22/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to analyze the beliefs of health care professionals about the benefits of patient involvement in care during hospitalization. Methods: a descriptive, exploratory, qualitative study was conducted with 87 health professionals from a teaching hospital. Semi-structured interviews were conducted between December 2019 and January 2020 - data was submitted to content analysis and interpreted in light of Rosenstock’s Model of Beliefs in Health. Results: participants included nursing technicians, nurses, doctors, and other professionals. The categories “Professionals’ beliefs about patient involvement in care”, “Practices of patient involvement in care” and “Factors favoring patient involvement in hospital care” emerged. The perception of professionals revealed the influence of patient involvement in care outcomes and benefits for the safety of care. Final Considerations: involving the patient in care is associated with the healthcare professional’s belief in the benefits of this practice for reducing incidents.
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Germossa GN, Sjetne IS, Småstuen MC, Hellesø R. Patient Satisfaction With a Nurse-Led Pain Management Program: A Quasi-Experimental Study in Ethiopia. SAGE Open Nurs 2022; 8:23779608221141237. [DOI: 10.1177/23779608221141237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Patient satisfaction is one of the important indicators of quality care. Objective To examine patient ratings of pain management satisfaction before and after introducing a nurse-led management program. Methods A quasi-experimental design with three cross-sectional surveys between October 1, 2016 and June 15, 2017. A total of 845 patients admitted to the four inpatient departments (medicine, surgery, maternity, and gynecology) of Jimma University Medical Centre were invited to participate in the study. A questionnaire adapted from the American Pain Society Patient Outcome Questionnaire, Pain Treatment Satisfaction Scale, and related literature was used for the survey. Data were analyzed using the chi-square test (categorical variables), t-tests for continuous variables, and robust regression to determine the effect of nurse-led management program on patient satisfaction. For all tests, p-values <.05 were considered statistically significant. Results Of the 845 patients invited, 782 (92.5%) participated in the surveys—Survey 1: N = 256; Survey 2: N = 259; Survey 3: N = 267. The proportion of patients who perceived that staff responded within 30 min increased from 67.8% in Survey 1 to 71.1% in Survey 2 and 74.2% in Survey 3. On a scale of 1 to 5 (1 = strongly dissatisfied and 5 = strongly satisfied), the overall mean patient satisfaction with pain management was 3.61 (SD 0.80) in Survey 1, 3.81 (SD 0.86) in Survey 2, and 4.10 (SD 0.64) in Survey 3. Moreover, the patients scored significantly higher on all satisfaction items in Survey 2 (B ranged between 0.12 and 0.41) and Survey 3 (B ranged between 0.24 and 0.74) compared to Survey 1. Conclusion The patients’ ratings of their satisfaction and staff nurse responsiveness following the nurse-led pain management program have increased compared to the levels before the intervention. However, further studies, including those with a control group, are warranted to confirm the results.
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Affiliation(s)
- Gugsa Nemera Germossa
- School of Nursing, Jimma University Institute of Health Sciences, Jimma University, Jimma, Ethiopia
- Department of Nursing Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Ragnhild Hellesø
- Department of Nursing Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Souza ADZD, Hoffmeister LV, Moura GMSSD. FACILITATORS AND BARRIERS OF PATIENT INVOLVEMENT IN HOSPITAL SERVICES: INTEGRATIVE REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2020-0395en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective to identify the facilitating factors and barriers that influence patient involvement in hospital services. Method integrative review; search of articles published between January 2011 and December 2020, in the electronic databases PubMed, Web of Science, Cinahl, Lilacs and Scopus, using descriptors related to "patient involvement", Barriers, Facilitators, in English, Spanish and Portuguese. Data collection was performed from May to June 2021, identifying 32 publications that met the inclusion criteria. Results the analysis resulted in three categories of facilitating factors and barriers: communication, actors of involvement and organizational culture, allowing the elaboration of a theoretical model of patient involvement. This model shows that in the centrality of the process are the actors involved, that is, patients and professionals, inserted in an organizational context, being influenced by leadership, culture, environment, available resources and processes, where communication permeates as a basis for involvement. Conclusion the facilitating factors and barriers identified in this review, synthesized in a theoretical model, allow transcending theoretical knowledge for practice. The complexity to operationalize this model requires patients, professionals, health services and society join forces to make this theoretical proposition a practice incorporated by the services.
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Affiliation(s)
| | - Louíse Viecili Hoffmeister
- Universidade NOVA de Lisboa, Portugal; Comprehensive Health Research Center, Portugal; Escola Superior de Enfermagem de Lisboa, Portugal
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Souza ADZD, Hoffmeister LV, Moura GMSSD. FACILITADORES E BARREIRAS DO ENVOLVIMENTO DO PACIENTE NOS SERVIÇOS HOSPITALARES: REVISÃO INTEGRATIVA. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2020-0395pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo identificar os fatores facilitadores e as barreiras que influenciam no envolvimento do paciente nos serviços hospitalares. Método revisão integrativa; realizada busca de artigos publicados entre janeiro de 2011 e dezembro de 2020, nas bases eletrônicas PubMed, Web of Science, Cinahl, Lilacs e Scopus, utilizando descritores relacionados a “patient involvement”, Barriers, Facilitators, nos idiomas inglês, espanhol e português. Coleta de dados realizada de maio a junho de 2021, identificando-se 32 publicações que atenderam aos critérios de inclusão. Resultados a análise resultou em três categorias de fatores facilitadores e barreiras: comunicação, atores do envolvimento e cultura organizacional, permitindo a elaboração de um modelo teórico de envolvimento do paciente. Esse modelo mostra que na centralidade do processo estão os atores envolvidos, ou seja, pacientes e profissionais, inseridos em um contexto organizacional, sendo influenciados pela liderança, cultura, ambiente, recursos disponíveis e processos, onde a comunicação perpassa como base para o envolvimento. Conclusão os fatores facilitadores e as barreiras identificadas nesta revisão, sintetizados num modelo teórico, permitem transcender o conhecimento teórico para a prática. A complexidade para operacionalizar esse modelo requer que pacientes, profissionais, serviços de saúde e sociedade unam os esforços para tornar esta proposição teórica em uma prática incorporada pelos serviços.
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Affiliation(s)
| | - Louíse Viecili Hoffmeister
- Universidade NOVA de Lisboa, Portugal; Comprehensive Health Research Center, Portugal; Escola Superior de Enfermagem de Lisboa, Portugal
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Anderson NN, Baker GR, Moody L, Scane K, Urquhart R, Wodchis WP, Gagliardi AR. Organizational capacity for patient and family engagement in hospital planning and improvement: interviews with patient/family advisors, managers and clinicians. Int J Qual Health Care 2021; 33:6413798. [PMID: 34718601 PMCID: PMC8678957 DOI: 10.1093/intqhc/mzab147] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/23/2021] [Accepted: 10/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Patient and family engagement (PE) in healthcare planning and improvement achieves beneficial outcomes and is widely advocated, but a lack of resources is a critical barrier. Little prior research studied how organizations support engagement specifically in hospitals. OBJECTIVE We explored what constitutes hospital capacity for engagement. METHODS We conducted descriptive qualitative interviews and complied with criteria for rigour and reporting in qualitative research. We interviewed patient/family advisors, engagement managers, clinicians and executives at hospitals with high engagement activity, asking them to describe essential resources or processes. We used content analysis and constant comparison to identify themes and corresponding quotes and interpreted findings by mapping themes to two existing frameworks of PE capacity not specific to hospitals. RESULTS We interviewed 40 patient/family advisors, patient engagement managers, clinicians and corporate executives from nine hospitals (two < 100 beds, four 100 + beds, three teaching). Four over-arching themes about capacity considered essential included resources, training, organizational commitment and staff support. Views were similar across participant and hospital groups. Resources included funding and people dedicated to PE and technology to enable communication and collaboration. Training encompassed initial orientation and project-specific training for patient/family advisors and orientation for new staff and training for existing staff on how to engage with patient/family advisors. Organizational commitment included endorsement from the CEO and Board, commitment from staff and continuous evaluation and improvement. Staff support included words and actions that conveyed value for the role and input of patient/family advisors. The blended, non-hospital-specific framework captured all themes. Hospitals of all types varied in the availability of funding dedicated to PE. In particular, reimbursement of expenses and compensation for time and contributions were not provided to patient/family advisors. In addition to skilled engagement managers, the role of clinician or staff champions was viewed as essential. CONCLUSION The findings build on prior research that largely focused on PE in individual clinical care or research or in primary care planning and improvement. The findings closely aligned with existing frameworks of organizational capacity for PE not specific to hospital settings, which suggests that hospitals could use the blended framework to plan, evaluate and improve their PE programs. Further research is needed to yield greater insight into how to promote and enable compensation for patient/family advisors and the role of clinician or staff champions in supporting PE.
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Affiliation(s)
- Natalie N Anderson
- Toronto General Hospital Research
Institute, University Health Network, 200 Elizabeth
Street, Toronto M5G2C4, Canada
| | - G Ross Baker
- Institute of Health Policy,
Management and Evaluation, University of Toronto, 155
College Street, Toronto M5T 3M6, Canada
| | - Lesley Moody
- Princess Margaret Cancer Centre,
University Health Network, 610 University Avenue, Toronto,
ON M5G 2C1, Canada
| | - Kerseri Scane
- Patient Partnerships, University
Health Network, 200 Elizabeth Street, Toronto, ON M5G2C4,
Canada
| | - Robin Urquhart
- Department of Community Health and
Epidemiology, Dalhousie University, 5790 University
Avenue, Halifax, NS B3H 1V7, Canada
| | - Walter P Wodchis
- Institute of Health Policy,
Management and Evaluation, University of Toronto, 155
College Street, Toronto M5T 3M6, Canada
| | - Anna R Gagliardi
- Address reprint requests to: Anna R. Gagliardi, Toronto
General Hospital Research Institute, University Health Network, 200 Elizabeth
Street, Toronto, ON M5G3C4, Canada. Tel: +416-340-4800; Fax:
+416-340-4816; E-mail:
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Anderson NN, Baker GR, Moody L, Scane K, Urquhart R, Wodchis WP, Gagliardi AR. Approaches to optimize patient and family engagement in hospital planning and improvement: Qualitative interviews. Health Expect 2021; 24:967-977. [PMID: 33761175 PMCID: PMC8235895 DOI: 10.1111/hex.13239] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background Patient engagement (PE) in health‐care planning and improvement is a growing practice. We lack evidence‐based guidance for PE, particularly in hospital settings. This study explored how to optimize PE in hospitals. Methods This study was based on qualitative interviews with individuals in various roles at hospitals with high PE capacity. We asked how patients were engaged, rationale for approaches chosen and solutions for key challenges. We identified themes using content analysis. Results Participants included 40 patient/family advisors, PE managers, clinicians and executives from 9 hospitals (2 < 100 beds, 4 100 + beds, 3 teaching). Hospitals most frequently employed collaboration (standing committees, project teams), followed by blended approaches (collaboration + consultation), and then consultation (surveys, interviews). Those using collaboration emphasized integrating perspectives into decisions; those using consultation emphasized capturing diverse perspectives. Strategies to support engagement included engaging diverse patients, prioritizing what benefits many, matching patients to projects, training patients and health‐care workers, involving a critical volume of patients, requiring at least one patient for quorum, asking involved patients to review outputs, linking PE with the Board of Directors and championing PE by managers, staff and committee/team chairs. Conclusion This research generated insight on concrete approaches and strategies that hospitals can use to optimize PE for planning and improvement. On‐going research is needed to understand how to recruit diverse patients and best balance blended consultation/collaboration approaches. Patient or public contribution Three patient research partners with hospital PE experience informed study objectives and interview questions.
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Affiliation(s)
- Natalie N Anderson
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - G Ross Baker
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Lesley Moody
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kerseri Scane
- Patient Partnerships, University Health Network, Toronto, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
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Gagliardi AR, Martinez JPD, Baker GR, Moody L, Scane K, Urquhart R, Wodchis WP. Hospital capacity for patient engagement in planning and improving health services: a cross-sectional survey. BMC Health Serv Res 2021; 21:179. [PMID: 33632200 PMCID: PMC7908767 DOI: 10.1186/s12913-021-06174-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 12/30/2022] Open
Abstract
Background Patient engagement (PE) in planning or improving hospital facilities or services is one approach for improving healthcare delivery and outcomes. To provide evidence on hospital capacity needed to support PE, we described the attributes of hospital PE capacity associated with clinical quality measures. Methods We conducted a cross-sectional survey of general and specialty hospitals based on the Measuring Organizational Readiness for Patient Engagement framework. We derived a PE capacity index measure, and with Multiple Correspondence Analysis, assessed the association of PE capacity with hospital type, and rates of hand-washing, C. difficile infection rates and 30-day readmission. Results Respondents (91, 66.4%) included general: < 100 beds (48.4%), 100+ beds (27.5%), teaching hospitals (11.0%) and specialty (13.2%) hospitals. Most featured PE in multiple clinical and corporate departments. Most employed PE in a range of Planning (design/improve facilities 94.5%, develop strategic plans 87.9%), Evaluation/Quality Improvement (accreditation 91.2%, develop QI plans 90.1%) and Service Delivery activities (develop information/communication aids 92.3%). Hospitals enabled PE with multiple supports (median 12, range 0 to 25), most often: 76.9% strategic plan recognizes PE, 74.7% patient/family advisory council, and 69.2% pool of patient volunteers; and least often: 30.0% PE staff, 26.4% PE funding and 16.5% patient reimbursement or 3.3% compensation. Hospitals employed a range of less (inform, consult) and more (involve, partner) active modes of engagement. Two variables accounted for 29.6% of variance in hospital PE capacity index measure data: number of departments featuring PE and greater use of active engagement modes. PE capacity was not associated with general hospital type or clinical quality measures. Conclusions Hospitals with fewer resources can establish favourable PE conditions by deploying PE widely and actively engaging patients. Healthcare policy-makers, hospital executives and PE managers can use these findings to allocate PE resources. Future research should explore how PE modes and methods impact clinical outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06174-0.
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Affiliation(s)
- Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, Toronto, M5G2C4, Canada.
| | | | - G Ross Baker
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Lesley Moody
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kerseri Scane
- Patient Partnerships, University Health Network, Toronto, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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