Patient and Family Engagement in Hospitals

What’s the evidence-base for effectively promoting patient and family engagement with hospital care? A new report released by AHRQ aims to answer that question.  The environmental scan was done to support development of a new toolkit — planned for release in mid-2013 — to help both patients and providers work together to improve care. Findings from the review are organized into three key areas:

1. Individual characteristics, needs, and perspectives of patients, families, and health professionals. Both patients and providers agree that the care they receive or give is generally good, even when that may not always be the case. It’s no surprise that they differ in their view of good care, however. Providers focus primarily on clinical issues, while patients and families see personal interactions as the key to good care. Engagement barriers for patients include fear, uncertainty, and health literacy. Barriers for clinicians are professional norms and experiences, litigation fear, and perceived level of effort.
2. Organizational context, including both hospital structures and processes that influence engagement. Leadership strength, organizational culture, and discretionary resources are some of the many organizational aspects that can impact engagement. Motivators include competition, legislation/regulation, public reporting, awards, the desire to improve, occurrence of a sentinel event, and altruism.
3. Hospital-based interventions and materials to enhance engagement of patients and their families, especially as it relates to safety and quality. Organization-level strategies to enhance engagement focused on health care teams, communication, increasing patients knowledge and skills, and patient/family input into management and processes. Individual-level resources available were reviewed.

Knowledge gaps identified for effectively improving patient engagement include:

• Strategies are not geared to the hospital experiences of patients
• Individual tools are lacking that support system-level strategies
• Actionable support is lacking for individuals to participate in engagement behaviors
• There are few complementary materials
• Key usability criteria are lacking for training tools/resources
• Implementation guidance on engagement strategies is limited

Bottom line:  While there’s reasonably strong evidence from related fields, there is still not robust evidence supporting the effectiveness for existing approaches and tools to better engage patients and families in their hospital care.

Sources:

Maurer M and others, American Institutes for Research. Guide to patient and family engagement: environmental scan report. Agency for Healthcare Research and Quality, May 2012. http://www.ahrq.gov/qual/ptfamilyscan/

Engaging patients and families in the quality and safety of hospital care. Agency for Healthcare Research and Quality, June 2012.  http://www.ahrq.gov/qual/engagingptfam.htm

Related post: https://aharesourcecenter.wordpress.com/2011/03/15/achieving-exceptional-patient-family-focused-care-in-hospitals/

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org