Sarah Davis, William Caplan, Sally Kraft, Stephanie Berkson, Martha Gaines, William Schwab & Nancy Pandhi, Engaging Patients at the Front Lines of Primary Care Redesign: Operational Lessons for an Effective Program. 40 Jr. Comm. J. Qual. Patient Saf. 533 (2014).
Abstract
Background—The lack of patient engagement in quality improvement is concerning, given increasing recognition that this participation may be essential for improving both quality and safety. As part of an enterprise- side initiative to redesign primary care at the University of Wisconsin Health System, interdisciplinary primary care teams received training in patient engagement.
Methods—Organizational stakeholders held a structured discussion and used nominal group technique to identify the key components critical to fostering a culture of patient engagement and critical lessons learned. These findings were augmented and illustrated by review of transcripts of two focus groups held with clinic managers and 69 interviews with individual microsystem team members.
Results—From late 2009 to early 2014, 47 (81%) of 58 teams have engaged patients in various stages of practice improvement projects. Organizational components identified as critical to fostering a culture of patient engagement were alignment of national priorities with the organization's vision guiding the redesign, readily available external experts, involvement of all care team members in patient engagement, integration within an existing continuous improvement team development program, and an intervention deliberately matched to organizational readiness. Critical lessons learned were the need to embed patient engagement into current improvement activities, designate a neutral point person(s) to navigate organizational complexities, commit resources to support patient engagement activities, and plan for sustained team-patient interactions.
Conclusions—Current national health care policy and local market pressures are compelling partnering with patients in efforts to improve the value of the health care delivery system. The UW Health experience may be useful for organizations seeking to introduce or strengthen the patient role in designing delivery system improvements.
