Patient and Family Engagement in the Quality Improvement Process
What is patient and family engagement?
Patient engagement can be defined as “patients, families, their representative, and health professionals working in active partnership at various levels across the health care system – direct care, organizational design and governance, and policy making – to improve health and health care.” 1
Why is patient and family engagement important?
One qualitative study found that that patient involvement in quality improvement work could be beneficial and play an important role in achieving the desired changes.2
Healthcare improvement priorities that were established with patients were more aligned with the core components of the Chronic Care Model and led to increased alignment between patients and health professionals.3
The time commitment is minimal – involving patients in establishing healthcare improvement prioritiesonly increased the amount of time required to reach consensus by 10%.3
“Perhaps the most important change has been a growing recognition and insistence that care must be responsive to the preferences and values of the consumers of health care services, especially individual patients, and that their opinions about care are important indicators of its quality.”4
Practices with higher levels of patient and family involvement saw a connection between improved involvement and improved care for individual patients. Despite this, in a survey of 112 practices that were early adopters of the PCMH model, approximately one-third of practices involved patients with a continuing role in quality improvement.5
Involving patients in the development of patient information may improve the quality of the materials by making them more readable and understandable6
“Healthcare won’t get better until patients play a leading role in fixing it.”7
Patient engagement in the process of practice redesign resulted in improved patient satisfaction.8
How can we engage patients and families in the quality improvement process?
Several studies have identified key features that facilitate effective inclusion of patients’ features. These features include early involvement, effective communication channels, a non-hierarchical structure, and having clearly defined roles2, 9.
Working groups ought to have an equal mixture of health professionals and patients or patient representatives. The patients do not necessarily have to be representative of the clinic population as a whole.10
1.Carman, K. L.; Dardess, P.; Maurer, M.; Sofaer, S.; Adams, K.; Bechtel, C.; Sweeney, J., Health affairs (Project Hope) 2013,32 (2), 223-31.
2.Armstrong, N.; Herbert, G.; Aveling, E. L.; Dixon-Woods, M.; Martin, G., Health Expect 2013,16 (3), e36-47.
3.Boivin, A.; Lehoux, P.; Lacombe, R.; Burgers, J.; Grol, R., Implement Sci 2014,9.
4.Blumenthal, D., The New England journal of medicine 1996,335 (12), 891-4.
5.Han, E.; Hudson Scholle, S.; Morton, S.; Bechtel, C.; Kessler, R., Health affairs (Project Hope) 2013,32 (2), 368-75.
6.Nilsen, E. S.; Myrhaug, H. T.; Johansen, M.; Oliver, S.; Oxman, A. D., Cochrane Db Syst Rev 2006, (3).
7.Richards, T.; Montori, V. M.; Godlee, F.; Lapsley, P.; Paul, D., BMJ 2013,346, f2614.
8.Van Berckelaer, A.; DiRocco, D.; Ferguson, M.; Gray, P.; Marcus, N.; Day, S., J Am Board Fam Med 2012,25 (2), 192-8.
9.Boyd, H.; McKernon, S.; Mullin, B.; Old, A., The New Zealand medical journal 2012,125 (1357), 76-87.
10.Williamson, C., BMJ 1998,317 (7169), 1374-7.