MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Quality Standards, Evidence Development and Standards, Health Quality Ontario, Toronto, Ontario, Canada.
BMJ Open. 2019 Aug 5;9(8):e029693. doi: 10.1136/bmjopen-2019-029693.
To explore the extent of patient engagement in the development of best practice reports related to transitions from hospital to home.
Scoping review.
Electronic databases (MEDLINE, EMBASE, CINAHL, Scopus, Trip Database, DynaMed Plus and Public Health Plus) and multiple provincial regulatory agency and healthcare organisation websites.
We included best practice reports related to the transition from hospital to a long-term care facility, community dwelling or rehabilitation centre. We included documents disseminated in English between 1947 and 2019.
Two independent reviewers screened for eligibility and one extracted and analysed data using a data extraction tool we developed based on established patient engagement frameworks. Only records actively engaging patients were analysed (n=11). The methodological quality of actively engaging patients was assessed using domain 2 (item 5) of stakeholder involvement from the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.
The search yielded 1921 citations of which 23 met the inclusion criteria and were included for narrative synthesis. These were disseminated between 1995 and 2019, with 18 (78%) published after 2010. Most were conducted in North America (USA 43%, Canada 22%), Europe (UK 30%) and Australia (4%). Eleven (48%) actively involved patients, of which only two involved patients across all stages of development. Most involved patients through direct or indirect consultation. The mean AGREE II domain 2 item 5 score (of those that actively engaged patients) was 5.9 out of 7.
Only half of existing best practice reports related to the transition from hospital to home actively involved patients in report development. However, the extent of patient engagement has been increasing over time. More organisations should strive to engage patients throughout the best practice development process and provide patients with opportunities for shared leadership.
探讨患者参与制定与医院到家庭过渡相关最佳实践报告的程度。
范围综述。
电子数据库（MEDLINE、EMBASE、CINAHL、Scopus、Trip Database、DynaMed Plus 和 Public Health Plus）和多个省级监管机构及医疗机构网站。
我们纳入了与从医院转至长期护理机构、社区居住或康复中心相关的最佳实践报告。我们纳入了 1947 年至 2019 年间以英文发表的文献。
两名独立审查员筛选合格文献，其中一名使用我们基于既定患者参与框架开发的数据提取工具提取和分析数据。仅分析了积极与患者合作的文献（n=11）。使用利益相关者参与评估工具（AGREE II）的领域 2（项目 5）评估积极与患者合作的文献的方法学质量。
搜索结果产生了 1921 条引文，其中 23 条符合纳入标准，并进行了叙述性综合。这些文献发表于 1995 年至 2019 年期间，其中 18 篇（78%）发表于 2010 年之后。大多数研究来自北美（美国 43%，加拿大 22%）、欧洲（英国 30%）和澳大利亚（4%）。11 篇（48%）文献积极与患者合作，其中仅有 2 篇文献在报告开发的所有阶段都涉及患者。大多数文献通过直接或间接咨询来联系患者。积极与患者合作的文献中，AGREE II 领域 2 项目 5 的平均得分为 5.9 分（满分 7 分）。
只有一半与医院到家庭过渡相关的最佳实践报告积极邀请患者参与报告制定。然而，患者参与的程度随着时间的推移而增加。更多的组织应该努力在最佳实践的整个开发过程中让患者参与，并为患者提供共同领导的机会。
