Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Health Expect. 2021 Jun;24(3):967-977. doi: 10.1111/hex.13239. Epub 2021 Mar 24.
Patient engagement (PE) in health-care planning and improvement is a growing practice. We lack evidence-based guidance for PE, particularly in hospital settings. This study explored how to optimize PE in hospitals.
This study was based on qualitative interviews with individuals in various roles at hospitals with high PE capacity. We asked how patients were engaged, rationale for approaches chosen and solutions for key challenges. We identified themes using content analysis.
Participants included 40 patient/family advisors, PE managers, clinicians and executives from 9 hospitals (2 < 100 beds, 4 100 + beds, 3 teaching). Hospitals most frequently employed collaboration (standing committees, project teams), followed by blended approaches (collaboration + consultation), and then consultation (surveys, interviews). Those using collaboration emphasized integrating perspectives into decisions; those using consultation emphasized capturing diverse perspectives. Strategies to support engagement included engaging diverse patients, prioritizing what benefits many, matching patients to projects, training patients and health-care workers, involving a critical volume of patients, requiring at least one patient for quorum, asking involved patients to review outputs, linking PE with the Board of Directors and championing PE by managers, staff and committee/team chairs.
This research generated insight on concrete approaches and strategies that hospitals can use to optimize PE for planning and improvement. On-going research is needed to understand how to recruit diverse patients and best balance blended consultation/collaboration approaches.
Three patient research partners with hospital PE experience informed study objectives and interview questions.
患者参与医疗保健规划和改进是一种日益增长的实践。我们缺乏针对患者参与的循证指导,尤其是在医院环境中。本研究探讨了如何在医院优化患者参与。
本研究基于对具有高患者参与能力的医院各角色个体的定性访谈。我们询问了如何让患者参与进来,选择方法的理由以及解决关键挑战的方法。我们使用内容分析确定了主题。
参与者包括来自 9 家医院的 40 名患者/家庭顾问、患者参与管理人员、临床医生和管理人员(2 家<100 张床位,4 家 100 张+床位,3 家教学医院)。医院最常采用合作(常设委员会、项目团队),其次是混合方法(合作+咨询),然后是咨询(调查、访谈)。那些采用合作的人强调将观点融入决策中;那些采用咨询的人强调捕捉不同的观点。支持参与的策略包括让不同的患者参与进来,优先考虑对许多人有益的事情,将患者与项目匹配,培训患者和医疗保健工作者,让足够数量的患者参与进来,要求至少有一位患者参加法定人数,让参与的患者审查产出,将患者参与与董事会联系起来,并由管理人员、员工和委员会/团队主席倡导患者参与。
这项研究为医院优化规划和改进方面的患者参与提供了具体方法和策略的见解。需要进行进一步的研究,以了解如何招募不同的患者,并更好地平衡混合咨询/合作方法。
三位具有医院患者参与经验的患者研究伙伴为研究目标和访谈问题提供了信息。