Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
PLoS One. 2018 Oct 24;13(10):e0205173. doi: 10.1371/journal.pone.0205173. eCollection 2018.
There is a need for structure to achieve functional patient engagement within mental healthcare organizations, and for clarification on how to proceed on a strategic level. The aim of this paper is to shed light on the implementation of a strategic organizational structure for patient engagement in mental health by examining why and how to implement a structure, the organizational and environmental factors that facilitate or limit the process, and the perceived consequences of the implementation.
This paper evaluates the implementation of a strategic committee for patient engagement in a mental healthcare organization in Montreal (Quebec, Canada). The research was designed as a qualitative single case study using a deductive approach by means of a conceptual framework. Data sources consisted in ten semi-structured interviews, three focus groups, and organizational documents.
The strategic committee for patient engagement was implemented as a means to formalize patient partner participation, following the introduction of a vision of full citizenship. Important aspects of its implementation included its composition and role, the elaboration of a framework for patient partner participation, and finally, ongoing application and evaluation of the framework. Several facilitating factors were identified, including executive management support, leadership, and a vision behind the participation. Limiting factors mainly consisted of resistance towards patient participation and the existence of stigma. Consequences included increased and improved patient engagement, as well as reduced stigma within the organization.
This study shows that the implementation of a strategic organizational structure for patient engagement is comprehensive. It further shows the importance of a vision and an articulate leadership involving several actors. Further research is needed regarding the impact of this type of strategic structure on a clinical level.
在精神卫生保健组织中实现患者参与的功能需要有结构,并需要明确在战略层面上如何推进。本文的目的是通过考察实施患者参与精神卫生的战略组织结构的原因和方法、促进或限制这一过程的组织和环境因素,以及实施的感知后果,阐明这一问题。
本文评估了在蒙特利尔(加拿大魁北克省)的一家精神卫生保健组织中实施患者参与战略委员会的情况。这项研究是通过概念框架,采用演绎方法设计的定性单案例研究。数据来源包括十次半结构化访谈、三次焦点小组和组织文件。
患者参与战略委员会的实施是为了正式规范患者伙伴的参与,遵循全面公民身份的愿景。其实施的重要方面包括其组成和角色、患者伙伴参与框架的制定,以及最终对框架的持续应用和评估。确定了一些促进因素,包括执行管理层的支持、领导力和参与背后的愿景。限制因素主要包括对患者参与的抵制和污名的存在。结果包括增加和改善了患者的参与度,以及减少了组织内的污名。
本研究表明,实施患者参与的战略组织结构是全面的。它进一步表明了愿景和明确的领导力的重要性,涉及到多个参与者。需要进一步研究这种战略结构对临床层面的影响。