Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?

Abstract

Background: Around the world, many healthcare organizations engage patients as a quality improvement strategy. In Canada, the University of Montreal has developed a model which consists in partnering with patient advisors, providers, and managers in quality improvement. This model was introduced through its Partners in Care Programs tested with several quality improvement teams in Quebec, Canada. Partnering with patients in quality improvement brings about new challenges for healthcare managers. This model is recent, and little is known about how managers contribute to implementing and sustaining it using key practices. Methods: In-depth multi-level case studies were conducted within two healthcare organizations which have implemented a Partners in Care Program in quality improvement. The longitudinal design of this research enabled us to monitor the implementation of patient partnership initiatives from 2015 to 2017. In total, 38 interviews were carried out with managers at different levels (top-level, mid-level, and front-line) involved in the implementation of Partners in Care Programs. Additionally, seven focus groups were conducted with patients and providers. Results: Our findings show that managers are engaged in four main types of practices: 1-designing the patient partnership approach so that it makes sense to the entire organization; 2-structuring patient partnership to support its deployment and sustainability; 3-managing patient advisor integration in quality improvement to avoid tokenistic involvement; 4-evaluating patient advisor integration to support continuous improvement. Designing and structuring patient partnership are based on typical management practices used to implement change initiatives in healthcare organizations, whereas managing and evaluating patient advisor integration require new daily practices from managers. Our results reveal that managers at all levels, from top to front-line, are concerned with the implementation of patient partnership in quality improvement. Conclusion: This research adds empirical support to the evidence regarding daily managerial practices used for implementing patient partnership initiatives in quality improvement and contributes to guiding healthcare organizations and managers when integrating such approaches.

Investigating the healthcare pathway through patient’s experience and profiles: implications for the breast cancer healthcare providers

“…are similar in both public hospitals and private centres. This is line with previous ndings regarding the temporal and spatial dimensions of the health care process [7,18,19,20,21]. However, patients experienced the process very differently from an experiential perspective.…”

“…), affective (moods, feelings, and emotions), cognitive (thinking and conscious mental processes), physical (practical act of doing something and usability), and social (relationships, that occur during common experience) touch points [15,26,42]. Furthermore, recent studies on patient-breast cancer medical pathway highlight two major dimensions -the temporal dimension refers especially to the effective sequencing of the care delivery and treatments, and the spatial dimension related to the proximity of healthcare centres [18,19,20,21]. Thus, we consider that each concern refers to an experience dimension and might constitute challenging touch point for healthcare providers.…”

“…The HPST law [4] de nes the care pathway through a temporal (effective sequencing of care delivery) and a spatial dimensions (care delivery in or near the patient's home and region). Prior research investigated the right orchestration of consultations and care delivery [7,18,19,20,21], as well as the role of rigorous teamwork design [22,23] as key factors to improve healthcare process and patient experience.…”

Investigating the healthcare pathway through patient’s experience and profiles: implications for the breast cancer healthcare providers

“…are similar in either public hospitals or private centers. This is line with previous findings regarding the temporal and special dimensions of the health care process [7,18,19,20,21]. However, patients experienced the process very differently from an experiential perspective.…”

“…The HPST law defines the care pathway through a temporal (effective sequencing of care delivery) and a spatial dimensions (care delivery in or near the patient's home and territory). Prior research investigated the right orchestration of consultations and care delivery [7,18,19,20,21], as well as the role of rigorous teamwork design [22,23] as key factors to improve healthcare process and patient experience.…”