Optimizing patient partnership in primary care improvement: A qualitative study

Alidina, Shehnaz; Martelli, Peter F.; Singer, Sara J.; Aveling, Emma‐Louise

doi:10.1097/hmr.0000000000000250

Cited by 17 publications

(38 citation statements)

References 24 publications

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“…Findings Existing scholarship suggests that, once activated, patients can grow in their commitment to a "shared learning journey" and that their social identities can evolve from consultant to full partner. 15,27 Our study highlights elements of organizational culture-including transparency, capacity-building, leadership, attention to diversity and representation, and infrastructure investments-that promote travel along the pathway to shared governance of learning processes. Our data also indicate that, even for those systems that have made the most progress, achieving the ideal of robust patient engagement in governance of learning remains a work in process.…”

Section: Discussionmentioning

confidence: 93%

“…The QI literature documents critical challenges to meaningful involvement of patients including recruitment and retention, time commitment, lack of shared knowledge and experience, sociocultural barriers to partnership, and the difficulty of implementing change within complex systems. 14,15 The literature on engaging patients in research is growing, [16][17][18] but with few exceptions, strategies and typologies have not been tested or adapted for engagement specific to the governance functions within LHSs. In one notable single-institution study, Kraft et al document how patient engagement can be "hardwired" by, for example, establishing Patient/Family Advisory Councils (PFACs), training, and protocols for volunteers.…”

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confidence: 99%

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Patients' roles in governance of learning: Results from a qualitative study of 16 learning healthcare systems

Grob

Gleason

McLean³

et al. 2021

Learning Health Systems

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Patient and family engagement has been identified as key to fulfilling Learning Healthcare Systems' (LHSs') promise as a model for improving clinical care, catalyzing research, and controlling costs. Little is known, however, about the state of patient engagement in the learning mission of these systems or about what governance structures and processes facilitate such engagement. Here, we report on an interview study of 99 patient and employee leaders in 16 systems. We found both variable levels of engagement and broad agreement that shared governance of learning remains a work in progress. We also identified a range of practices that can support or thwart development of an organizational culture conducive to shared governance, including transparency, capacity building, infrastructure investment, leadership, attention to diversity of patient partners, and committee structures. In LHSs with most sophisticated shared governance, both employees and patients contribute to building a democratic learning culture.

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

Patients' roles in governance of learning: Results from a qualitative study of 16 learning healthcare systems

Grob

Gleason

McLean³

et al. 2021

Learning Health Systems

View full text Add to dashboard Cite

show abstract

“…3 37 42 47 51 52 57-65 A need to be flexible in unfamiliar and evolving situations was also reported, including dealing with uncertainty as QI initiatives progress 66 ; patients collaborating when unsure about what was involved 39 and staff accepting that roles may evolve in unpredictable ways. 67…”

Section: Personal Attributes Domainmentioning

confidence: 99%

“…66 71 Strong conflict resolution and negotiation skills were viewed as paramount both for patients and staff. 4 9 22 58 66 Building respectful, constructive and reciprocal relationships was highlighted, 10 50 66 with honesty, 42 patient avoidance of a combative approach 63 and a virtuous cycle of a shared journey 67 emphasised. Advocating for everyone rather than personal interests was also considered valuable.…”

Section: Relationships and Communication Domainmentioning

confidence: 99%

“…The Philosophies, Models and Practices domain focuses on capabilities which enable patients and staff to work effectively within an organisational context and with the requisite practical skills. Works within organisational priorities, governance, policies, resources and constraints was viewed as an essential capability as this reduced patient frustration, 67 and enabled shared insights into the changes needed. 38 70 Abilities to work within confidentiality requirements, 3 47 50 57 committee procedures 45 48 58 60 and patient reimbursement and compensation guidelines 4 39 54 56 were also discussed.…”

Section: Philosophies Models and Practices Domainmentioning

confidence: 99%

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Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review

et al. 2021

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BackgroundInternationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration.ObjectivesThe research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities?MethodsA six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis.ResultsForty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients’ co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported.ConclusionThe framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated.

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Experiences of persons with multiple sclerosis of a collaborative care programme: A qualitative study

et al. 2023

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AimThis study aimed to explain the experiences of individuals with multiple sclerosis (MS) about the collaborative care programme.DesignThis qualitative study was conducted from July 2021 to March 2022.MethodsWe conducted this study with individuals with MS who participated in the collaborative care programme in Hamadan, Iran. A purposive sampling with maximum variety was applied to recruit patients until data saturation. Eventually, 18 patients consented and were interviewed using a semi‐structured interview guide. The transcriptions of audio‐checked interviews were analysed using a conventional content analysis approach of Graneheim and Lundman by MAXQDA 10, 2010 edition.ResultsThe study identified three main categories. that emerged from the participants' experiences of collaborative care: the ‘Beginning of Communication’, which included two subcategories, ‘Introduction and Acquaintance with Each Other’ and ‘Formation of Trust’; ‘Mutual Interaction’, which included three subcategories, ‘Dialogue’, ‘Mutual Goal Setting’ and ‘Mutual Agreement of Care Solutions’; and ‘Exchange of Targeted Behaviors’, which included six categories, Implementation of Strategies for ‘Nutritional Behaviors’, ‘Sleep and Rest’, ‘Constipation Relief’, ‘Promotion of Physical Activity and Exercise’, ‘Fatigue Reduction’ and ‘Stress Management’.ConclusionsThe findings highlight the statistically significant role of collaborative care in MS management. Utilizing these research findings can update the development of interventions based on collaborative care, which can provide appropriate support to individuals with MS.Patient or public contributionIndividuals with multiple sclerosis.

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Optimizing patient partnership in primary care improvement: A qualitative study

Abstract: Supplemental digital content is available in the text.

Cited by 17 publications

References 24 publications

Patients' roles in governance of learning: Results from a qualitative study of 16 learning healthcare systems

Patients' roles in governance of learning: Results from a qualitative study of 16 learning healthcare systems

Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review

Experiences of persons with multiple sclerosis of a collaborative care programme: A qualitative study

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