By Jennifer Sweeney
Patients and clinicians need help understanding how they can work together, not only to achieve the best health outcomes, but to transform the health care system to be patient- and family-centered. This work requires changes in thinking and in behavior. Clinicians as well as patients and families need help navigating the new terrain.
There are tremendous opportunities to build partnerships between clinicians and patients. New care delivery and payment models are being developed and implemented as a result of the Affordable Care Act. Many stakeholders recognize that previous attempts to transform the system failed because patients and families were not at the table.
At the National Partnership for Women & Families, we are working with three patient care and quality improvement models rolled out of the Centers for Medicare and Medicaid Services in the past 18 months: the Pioneer ACO Model, the Comprehensive Primary Care initiative, and the Partnership for Patients initiative. In each, we are helping to build partnerships between clinicians and patients and families.
During the first year of the Comprehensive Primary Care initiative, practices had to pursue several milestones, with one specifically around patient and family engagement. They could do that either by going through a Clinician and Group-CAHPS survey process, and/or by creating a patient and family advisory council that meets several times a year to help the practice redesign care.
These councils can help practices meet their engagement goals but, more importantly, they offer an opportunity to redesign care delivery to better meet patients’ needs. For example, practices are working with patients to design patient portals, reconfigure patient flow, address appointment scheduling, and design/select decision-making tools.
Hospitals with the Partnership for Patients initiative are partnering with patients and families to achieve quality improvement goals such as reducing preventable readmissions. For example, patients and families are providing guidance as hospitals modify their discharge processes and discharge summary documents to give patients and families the information and resources they need when they return home.
It’s important to emphasize that patient and family engagement is not about “compliance.” It’s not about education campaigns aimed at changing patient behavior. And it is not about getting patients to interact more effectively with a system that was not designed by them or with them. It’s about giving patients and families a real voice in the design and delivery of care.
Patients are better positioned than anyone to tell us about their experiences with care, and they have ideas and insights that could vastly improve our ability to meet their needs. We know that when patients and families are genuinely integrated into the care team and into redesign efforts, outcomes are better and care is safer. It’s also important to underscore that partnering with patients and families has tremendous benefits for clinicians and staff as well, including improved job satisfaction. A chief nursing officer shared an important insight with me recently: “This is the first time we’ve engaged patients and families in a real way in anything we’ve done, and it feels really good.”
There is no “one size fits all” method to patient and family engagement. I’d encourage health care providers to think about where they are challenged and then reach out to patients and families to help them mitigate those challenges. If a unit is struggling with medication management, unit leaders could invite patients and families who have received care in that unit to join a working group aimed at creating tools, processes, and resources to help both patients and staff better manage medications.
There are a couple of things health care providers should keep in mind if they decide to work collaboratively with patients and families. The most important is to engage them at the outset. To build successful partnerships, it’s important to engage patients and families in the design, implementation, and evaluation of quality improvement initiatives, process changes, and policy modifications. The system has a greater chance of meeting patient needs and getting to the triple aim if we work with patients and families rather than doing things on our own.
Clinician leaders within hospitals and teaching facilities have an opportunity to set a standard of patient- and family-centered care. They can communicate an expectation that we cannot transform the system without the insights and experiences of patients and families.
In the future, it would be great to see more tools and resources on engaging patients and families in additional areas beyond the point of care. While we need greater patient access to shared decision-making tools, we also need tools and educational opportunities that encourage patient participation in health care governance, redesign, policy, and stronger connections between the health care system and community resources.
—Jennifer Sweeney is the Director of Consumer Engagement and Community Outreach at the National Partnership for Women & Families. She sits on the Center for Medical Technology’s Patient and Consumer Advisory Committee and the Joint Commission’s Patient and Family Advisory Board. She is a frequent speaker on health care issues, with a particular focus on consumer stakeholder engagement strategies. She can be reached at JSweeney@nationalpartnership.org.
We want to hear from you! What innovative models and programs are you working on at your institution to foster consumer engagement and partnerships between clinicians, patients, and their families?