Patient engagement is an essential component of safe, appropriate, high quality healthcare. But what do we mean by patient engagement and how does it relate to patients’ experience of care?
A recent report published by the National Patient Safety Foundation (NPSF) notes that most definitions of patient engagement include the common themes of "partnership, communication, information exchange and respect.”
The Beryl Institute defines patient experience as "the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”
There are overlaps between patient experience of care and patient engagement. If patients are not respected as partners in their care and if clinicians do communicate with patients effectively, then it is highly unlikely that the patient’s experience will be a positive one. Moreover, research has linked patient experience to clinical outcomes, with a 2013 paper finding "patient experience is positively associated with clinical effectiveness and patient safety and [data] support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare.”
The NPSF report, Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human, makes a number of recommendations for improving patient engagement to improve patient safety:
- Training and education: Clinicians and health professionals need to be educated about concepts such as shared decision making, health literacy, cultural sensitivity and respect.
- Ease of access to information: Patients and families need timely access to medical records, test results and tools and resources that help them understand complex medical information.
- Patient representation: Members of the community served by a healthcare organization should be represented on the governing bodies and committees of those organizations. Only by such representation can we ensure that safety and quality initiatives and care processes that affect patient experience are designed with patients in mind.
- Tools and strategies: From including families in bedside rounding to the use of tools like the Ask Me 3 program, which encourages patients to ask key questions about their health and care plans, there are tools and strategies that can help engage patients and improve their experience of care.
- Reporting and measuring: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) serves to measure, to a degree, a patient’s experience of care while hospitalized. We also need ways to measure patient engagement, including ways to capture patient reports of safety lapses.
Arguing for greater patient and family engagement is not new to NPSF, and is in fact an issue that we and others have been advocating for some time now. While educational efforts such as the Agency for Healthcare Research and Quality’s Questions are the Answer campaign are useful for patients and consumers, we also know that even experienced health professionals sometimes have trouble speaking up when put in the vulnerable position of patient.
While patients should be encouraged to be full partners in their care, their clinicians are the ones who really hold the key to making that possible.
Improving patient and family engagement is one of eight recommendations in the new NPSF report, which is a focal point of Patient Safety Awareness Week, March 13-19, 2016. The theme of the week this year is United for Patient Safety, a reflection of the belief that clinicians, patients, policy makers, researchers and everyone involved in healthcare must be part of making care safer for everyone.
Tejal K. Gandhi, MD, MPH, CPPS, is President and Chief Executive Officer of the National Patient Safety Foundation, the NPSF Lucian Leape Institute and the Certification Board for Professionals in Patient Safety. She is advocating for patient safety at the national level, driving educational and professional certification efforts, and helping to create and spread innovative new safety ideas.