Consumer input into health care: Time for a new active and comprehensive model of consumer involvement

Abstract

BackgroundTo ensure the provision of patient‐centred health care, it is essential that consumers are actively involved in the process of determining and implementing health‐care quality improvements. However, common strategies used to involve consumers in quality improvements, such as consumer membership on committees and collection of patient feedback via surveys, are ineffective and have a number of limitations, including: limited representativeness; tokenism; a lack of reliable and valid patient feedback data; infrequent assessment of patient feedback; delays in acquiring feedback; and how collected feedback is used to drive health‐care improvements.ObjectivesWe propose a new active model of consumer engagement that aims to overcome these limitations. This model involves the following: (i) the development of a new measure of consumer perceptions; (ii) low cost and frequent electronic data collection of patient views of quality improvements; (iii) efficient feedback to the health‐care decision makers; and (iv) active involvement of consumers that fosters power to influence health system changes.

Patient and carer involvement in healthcare education, service delivery and research: avoiding tokenism

“…Input ranges from service design and delivery, across the research processes to the development, delivery and evaluation of programmes of study offered to healthcare students. The overarching aim is to ensure healthcare delivery, research and the preparation of health professionals is more responsive to the needs of the patient and their carers 1. Valuing and listening to patients and carers is central to the quality agenda, including ensuring care is patient and family centred, and there is appropriate use of resources that meets patient needs figure 1.…”

Participatory action research to pilot a model of mental health service user involvement in an Ethiopian rural primary healthcare setting: study protocol

“…Working in a collaborative and non-hierarchical manner may facilitate deeper understanding of how implementation can be achieved [56,84,100,112,121]. Furthermore, the dialogue and critical reflection incorporated within PAR enables participants to challenge the status quo of professional-dominated health systems, dismantle unequal power relations between service users/caregivers and those within health systems and society and create fruitful communication [121][122][123]. C) PAR also rejects objectivist assumptions that distance the researcher and the participants from one another [121,123].…”

“…Furthermore, the dialogue and critical reflection incorporated within PAR enables participants to challenge the status quo of professional-dominated health systems, dismantle unequal power relations between service users/caregivers and those within health systems and society and create fruitful communication [121][122][123]. C) PAR also rejects objectivist assumptions that distance the researcher and the participants from one another [121,123]. The close proximity of working can promote inclusion and confront engrained stigma and prejudices [32,120,124].…”

Using co‐creation and multi‐criteria decision analysis to close service gaps for underserved populations

“…To identify service gaps not identified by service mapping, consumer engagement can provide a patient-centred perspective 19 and is increasingly recognized as an essential element in service design and quality improvement. [20][21][22] Consumer engagement also has the potential to generate solutions and prioritize action.…”

“…20 While consumer engagement can take many forms, one recent example of good practice in consumer engagement (a) surveyed perceptions of service quality in a representative sample of service users to prioritize broad areas for improvement, (b) convened a Consumer Action Group of hospital staff and consumer representatives to develop and implement quality improvements and (c) used feedback from subsequent iterations of the consumer survey to fine-tune quality improvements and prioritize next steps. 19 When prioritizing areas for improvement in this example, respondents to the consumer survey allocated a fixed number of "points" across their top five areas for improvement (eg improved parking, information, hospital catering) to indicate a relative preference for changes in one area over another. When developing potential quality improvements, the Consumer Action Group followed an adapted version of the Breakthrough Series model, with an emphasis on collaborative learning rather than co-design or cocreation.…”