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Learning From Patients. Engaging Patients in Primary Care Tanya Lord, PhD. Learning Objectives. By the end of this module you will be able to: Demonstrate the difference between engaging patients in their own healthcare and practice improvement
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Learning From Patients Engaging Patients in Primary Care Tanya Lord, PhD
Learning Objectives By the end of this module you will be able to: • Demonstrate the difference between engaging patients in their own healthcare and practice improvement • Describe three ways that engaging patients can be valuable to your practice (own healthcare and practice improvement) • Understand/use patient engagement methods
Patient Engagement "Nothing about me without me" was the concept of a five-day global seminar held in 1998 to develop ideas for improving the quality of healthcare by involving patients. “Nothing about me without me.”
Clinical Relationship:Why Engage Patients? Patients are becoming more informed! • Improves communication • Improves diagnosis • Improves family history • Provides better understanding • Barriers to care • Adherence to treatment and medical advice
Clinical Relationship:How to Engage Patients? • Inform • Provide information on diagnosis and treatment plan • Provide health education • Involve • Ask patient’s opinion • Discuss options based on patient’s • Priorities, preferences, perspectives • Use patient portals or other IT methods to connect • Partner • Share understanding of expectations • Solve problems and set goals jointly • Share decision making
Shared Decision Making:Partnering with Patients • Providers and patients exchange important information • Providers help patients understand medical evidence about the decision they are facing • Patients help providers understand their needs, values, and preferences concerning these decisions • After time to reflect, patients and providers decide together on a care plan consistent with medical science and personalized to the patient Reference: Gafni 1997.
Clinical Relationship: Involve AGENDA SETTING FORM
Clinical Relationship: Involve WHAT ELSE ???
Clinical Relationship: Partner Behavior Changes “Do you mind if I give you some advice about that?” Treatment Changes “Do you mind if I give you some recommendations regarding your treatment”
Practice Improvement: Why Engage Patients/Families? • Provide unique insights and perspectives on practice policies and procedures
Practice Improvement: Why Engage Patients/Families? • Provide unique insights and perspectives on practice policies and procedures • Provide innovative ideas for improvement
Practice Improvement: Why Engage Patients/Families? • Provide unique insights and perspectives on practice policies and procedures • Provide innovative ideas for improvement • Maintain a tireless passion and interest
Practice Improvement: How to Engage Patients/Families? • Inform • Tell patient improvements being made on their behalf • Involve • Solicit patient input (suggestion box) • Choose initiatives based on patient input • Ask patients after an improvement initiative • Did things improve? What worked? What didn’t? • Partner • Include patient at the beginning of initiatives • Create patient advisory council
Effective Engagement Basic Principles: • Designate a staff member or key contact for working patients
Effective Engagement Basic Principles: • Designate a staff member or key contact for working patients • Provide opportunities where patients can make a real difference
Effective Engagement Basic Principles: • Designate a staff member or key contact for working patients • Provide opportunities where patients can make a real difference • Clearly define expectations, including timelines, deadlines, and responsibilities for both patients and staff
Ready to Partner with Patients? Can you answer ‘yes’ to these questions? • I believe that patient opinion and input are valuable to this practice • I believe that patients and family members bring a perspective to a project that no one else can provide • We are able and willing to make time to engage patients • We have patients who have expressed opinions, just not in a formal method • I am willing to create a culture where patients feel comfortable to speak freely
PROMISES: Patient Engagement Informing Patients • Patients are educated about what to ask at the pharmacy
PROMISES: Patient Engagement Involve Patients • Patient surveys • Suggestion boxes
PROMISES: Patient Engagement Partnering with Patients Including a patient in planning how to improve rates of colonoscopy • Offered insight about trust and relationship with clinicians
Other Ideas—Invite Patients: • To attend evening meetings to discuss improvement planning (1/month, 1/quarter) • To speak at a staff meeting • To attend your improvement discussions
Recruit Patients That: • Have patient experience in your organization
Recruit Patients That: • Have patient experience in your organization • Have concern for more than one issue
Recruit Patients That: • Have patient experience in your organization • Have concern for more than one issue • Can express their experiences constructively
Recruit Patients That: • Have patient experience in your organization • Have concern for more than one issue • Can express their experiences constructively • Are representative of your patient population
Ready to Partner with Patients? Can you answer ‘yes’ to these questions? • I believe that patient opinion and input are valuable to this practice • I believe that patients and family members bring a perspective to a project that no one else can provide • We are able and willing to make time to engage patients • We have patients who have expressed opinions, just not in a formal method • I am willing to create a culture where patients feel comfortable to speak freely
Getting Ready! • Ask: What internal changes are needed to become open to having patient input? • Discuss barriers to partnering with patients • Evaluatestaff readiness • Brainstorm how patients could be valuable to the practice • PDSA: Start small and test each idea
Our Greatest Asset “The greatest asset we have underutilized is all the assets of the patient.” Maureen Bisognano President and CEO Institute for Healthcare Improvement
Thank You! Thank you for your time and attention today
A Few References • Charles C, Gafni A,Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681–92. • Salzburg statement on shared decision making.BMJ 2011;342:d174.5