Hospital capacity for patient engagement in planning and improving health services: a cross-sectional survey

Abstract

Background Patient engagement (PE) in planning or improving hospital facilities or services is one approach for improving healthcare delivery and outcomes. To provide evidence on hospital capacity needed to support PE, we described the attributes of hospital PE capacity associated with clinical quality measures. Methods We conducted a cross-sectional survey of general and specialty hospitals based on the Measuring Organizational Readiness for Patient Engagement framework. We derived a PE capacity index measure, and with Multiple Correspondence Analysis, assessed the association of PE capacity with hospital type, and rates of hand-washing, C. difficile infection rates and 30-day readmission. Results Respondents (91, 66.4%) included general: < 100 beds (48.4%), 100+ beds (27.5%), teaching hospitals (11.0%) and specialty (13.2%) hospitals. Most featured PE in multiple clinical and corporate departments. Most employed PE in a range of Planning (design/improve facilities 94.5%, develop strategic plans 87.9%), Evaluation/Quality Improvement (accreditation 91.2%, develop QI plans 90.1%) and Service Delivery activities (develop information/communication aids 92.3%). Hospitals enabled PE with multiple supports (median 12, range 0 to 25), most often: 76.9% strategic plan recognizes PE, 74.7% patient/family advisory council, and 69.2% pool of patient volunteers; and least often: 30.0% PE staff, 26.4% PE funding and 16.5% patient reimbursement or 3.3% compensation. Hospitals employed a range of less (inform, consult) and more (involve, partner) active modes of engagement. Two variables accounted for 29.6% of variance in hospital PE capacity index measure data: number of departments featuring PE and greater use of active engagement modes. PE capacity was not associated with general hospital type or clinical quality measures. Conclusions Hospitals with fewer resources can establish favourable PE conditions by deploying PE widely and actively engaging patients. Healthcare policy-makers, hospital executives and PE managers can use these findings to allocate PE resources. Future research should explore how PE modes and methods impact clinical outcomes.

Organizational capacity for patient and family engagement in hospital planning and improvement: interviews with patient/family advisors, managers and clinicians

“…Prior research regarding PE largely focused on engaging individuals in their own clinical care or as members of research teams [ 10 , 15 , 16 ]. For example, a scoping review of 87 articles described how patients participated in their own care while hospitalized [ 10 ], and a systematic review of 142 studies described identified the research tasks in which patients were most commonly engaged and barriers of doing so resulted in potentially tokenistic involvement [ 16 ].…”

Refining a capability development framework for building successful consumer and staff partnerships in healthcare quality improvement: A coproduced eDelphi study

“…However, this conflicts with research that identified that smaller, nonteaching hospitals displayed a higher organizational capacity for CCI than some large teaching hospitals pointing to the critical influence of organizational culture and leadership. 2 Nongovernment organizations, primary care, and residential care were also identified as settings where framework implementation may be challenging. This requires research as there are many examples of highly effective CCI for QI in primary care, in particular.…”

“…Globally, patient and family engagement is gaining momentum as a strategy to improve quality and safety across the continuum of health services. 1 , 2 The language used internationally to encompass the concepts of patient and family engagement varies and includes patient and public participation, patient and public involvement and engagement, stakeholder engagement, and consumer and community involvement (CCI). CCI will be used throughout this paper as the research originated in Australia where that terminology is widely used.…”

Approaches to optimize patient and family engagement in hospital planning and improvement: Qualitative interviews

“…We also used snowball sampling by first interviewing PE managers, who referred us to patients/family and clinicians. We recruited participants from hospitals with high PE capacity, identified by a survey of hospital PE managers that we had administered in the year prior to these interviews 15 . High PE hospitals were those that featured PE in planning and improvement activities across multiple clinical and corporate departments and employed a variety of engagement approaches.…”

“…We recruited participants from hospitals with high PE capacity, identified by a survey of hospital PE managers that we had administered in the year prior to these interviews. 15 High PE hospitals were those that featured PE in planning and improvement activities across multiple clinical and corporate departments and employed a variety of engagement approaches. We aimed to recruit 1 PE manager, 2 patient/family and 2 clinicians from 2 hospitals of each type for a minimum total of 30 interviews.…”