How do hospitals engage patients and family members in quality management? A grounded theory study of hospitals in Brazil

Saut, Ana Maria; Berssaneti, Fernando Tobal; Ho, Linda Lee; Berger, Simone

doi:10.1136/bmjopen-2021-055926

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…The literature also emphasizes that not all patients want to participate in activities other than those related to their care, and ‘willingness’ and ‘availability’ were requirements for participation at any level of engagement. From the perspective of institutions, on the other hand, some of them have barriers and restrictions on the sharing of information, especially in critical situations involving ‘care risk, legal risk or even image risk’ [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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How did healthcare professionals define patient engagement in quality management? A survey study

Saut

Berger

et al. 2023

BMC Health Serv Res

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Background Patient and family engagement (PFE) can positively impact the patient experience and care process outcomes. There is no unique type of PFE, and the process is usually defined by the quality management department or professionals responsible for this process in the hospital. The objective of this study is to define PFE in quality management based on the professional’s perspective. Method A survey was carried out with 90 professionals from Brazilian hospitals. There were two questions aimed at understanding the concept. The first was a multiple-choice question to identify synonyms. The second was an open-ended question to develop the definition. A content analysis methodology was employed by applying techniques for thematic and inferential analysis. Results Three words were classified as synonyms by more than 60% of respondents: involvement, participation, and centered care. The participants described patient participation at both the individual (related to the treatment) and organizational levels (related to quality improvement). The PFE in the treatment is related to the development, discussion and decision-making about the therapeutic plan, participation in each step of care, and knowledge of the institution's quality and safety processes. At the organizational level, engagement in quality improvement includes the involvement of the P/F in all processes of the institution, from strategic planning to the design or improvement processes, as well as active participation in institutional committees or commissions. Conclusion The professionals defined engagement in two levels (individual and organizational) and the results suggest that their point of view can influence the practice in the hospitals. Professionals of hospitals that implemented mechanisms of consult defined PFE more in the individual level. On the other hand, professionals of hospitals that implemented mechanisms of involvement considered PFE more focus in the organizational level.

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Section: Discussionmentioning

confidence: 99%

“…As stated by Saut et al [ 15 ], effective patient engagement involves changes in both process and culture. Patient engagement must be addressed in a more comprehensive and integrated way, considering all the essential elements related to processes and organizational culture.…”

Section: Introductionmentioning

confidence: 99%

How did healthcare professionals define patient engagement in quality management? A survey study

Saut

Berger

et al. 2023

BMC Health Serv Res

Self Cite

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Engaging healthcare professionals and patient representatives in the development of a quality model for hospitals: a mixed-method study

Bogaert,

Regge,

Vermassen

et al. 2024

International Journal for Quality in Health Care

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Background: Top-down and externally imposed quality requirements can lead to improvement, but do not seem as sustainable as intended. There is a need for a quality model that intrinsically motivates healthcare professionals to contribute to quality and safe care in hospitals. This study shows how a quality model that matches the identity and the quality vision of the organization was developed. Methods: A multimethod design with three phases was used in the development of the model at a large teaching hospital in Belgium. In the first phase, fourteen focus groups and nineteen interviews with staff members were conducted to obtain an overview of the quality and safety challenges; complemented by a plenary discussion with the members of the patient advisory council. In the second phase, the challenges that had been captured were further assessed using a hospital wide survey for all hospital staff. Finally, a newly established Quality Review Board (with internal and external stakeholders) critically evaluated the input of phase 1 and 2 and defined the basic quality standards to be implemented in the hospital. A first evaluation 2 years after the implementation was conducted based on (1) patients’ perceptions of quality of care and patient safety by publicly available indicators collected in 2016, 2019 and 2022, and (2) staff experiences and perceptions regarding the acceptability of the new model gathered through (grouped) interviews and an open questionnaire. Results: The quality model consists of eight broad themes, including norms for the hospital staff (n=27), sustained with quality systems (n=8) and organisational support (n=6), with aid from adequate management and leadership (n=6). The themes were converted into 46 standards. These should be supported within a safe, efficient and caring work environment. The new model was launched in the hospital in June 2021. The evaluation shows a significant difference in quality and safety on different dimensions as perceived by hospitalized patients. The perceived added value of the participatory model is a better fit with the needs of employees, and the fact that the model can be adjusted to the specific context of the different hospital departments. The lack of hard indicators is seen as a challenge in monitoring quality and safety. Conclusion: The participation of various stakeholders inside and outside the organisation in defining the quality challenges resulted in the creation of a participatory quality model for the hospital, which lead towards a better-supported quality policy in the hospital.

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Dealing with intervening factors in the patient engagement

Saut,

Ho,

Berssaneti

2024

IJQRM

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PurposeThere is evidence that quality improvement projects developed with the participation of patients and family members are more likely to result in a sustainable change. To identify the intervening factors is an important step in promoting and supporting patient and family members’ engagement.Design/methodology/approachA survey was carried out with 90 hospitals. A total of 35 intervening factors were evaluated by the healthcare professionals from the quality area using a Likert scale. Factor analysis was applied to identify the relationship among the factors and cluster analysis and the standardized scores for each new latent variable were obtained to observe the association between them and hospitals profile. Cluster analysis allowed to group the hospitals with similar responses and to analyze whether there was any association with the profile of the institutions.FindingsA total of ten intervening factors are identified: two in the financial dimension, five in the structural and three in the personal and cultural. The standardized scores of latent variables suggest that the financial factors could be affected by the hospital capacity. The structural factors could be impacted by the accreditation status, location (region) and administrative control (ownership). And the personal and cultural factors could be by the location and dominant organizational culture. All of factors are influenced by the performed quality management activities. The cluster analysis allowed the identification of three groups in the financial dimension, and four in the other two dimensions. Except for the accreditation status in the personal and cultural dimension, no evidence of association between the groups and the variables raised to characterize the profile of the hospitals was found.Originality/valueThe study contributed to identify the relationship among the intervening factors turning possible to simplify and reduce them more comprehensively than those originally identified in the literature and at the same time maintaining the representativeness of the original variables.

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How do hospitals engage patients and family members in quality management? A grounded theory study of hospitals in Brazil

Cited by 3 publications

References 32 publications

How did healthcare professionals define patient engagement in quality management? A survey study

How did healthcare professionals define patient engagement in quality management? A survey study

Engaging healthcare professionals and patient representatives in the development of a quality model for hospitals: a mixed-method study

Dealing with intervening factors in the patient engagement

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