Patients’ Views About Patient Engagement and Representation in Healthcare Governance

DeCamp, Matthew; Dukhanin, Vadim; Hebert, Luciana E.; Himmelrich, Sarah; Feeser, Scott; Berkowitz, Scott A.

doi:10.1097/jhm-d-18-00152

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…Second, consistent with prior findings from a survey of more than 3000 Medicare beneficiaries,participants believed that PFACs could improve perceptions of health‐care systems among their patients. Because patient perceptions and patient satisfaction matter for reputation, reflect care quality and can affect compensation under new payments models, PFACs may have untapped potential in this area.…”

Section: Discussionsupporting

confidence: 69%

“…Other findings lend themselves to additional practical recommendations that health‐care system leaders and PFAC members can use to improve how PFACs operate. Increasing awareness of PFACs (which by some estimates is approximately 50%, among patients in general) among non‐PFAC members may be the most important recommendation. Others include ensuring diversity in PFAC membership very broadly construed, rotating members over time, facilitating channels of communication between PFACs and the broader patient population, and evaluating PFAC effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…We recruited focus group participants from a sample of 429 JMAP patients who had indicated their willingness to provide deeper insights about their responses on a prior survey that assessed their awareness of patients representatives and how important patient representation is to them …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Who represents me? A patient‐derived model of patient engagement via patient and family advisory councils (PFACs)

Dukhanin

Feeser

Berkowitz

et al. 2019

Health Expectations

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Background: Despite increasing attention to patient and family advisory councils (PFACs), what patients who are not PFAC members expect of PFACs remains understudied. Understanding their expectations is critical if PFACs are to help health systems achieve certain outcomes (eg increased patient satisfaction with health systems). Objective: To obtain rich insights about what patients who are not PFAC members expect of PFACs. Design: From July to September 2018, we conducted a qualitative study using focus groups. Setting and participants: We recruited patients and caregivers who receive their care from the Johns Hopkins Medicine Alliance for Patients (JMAP), LLC, a Medicare accountable care organization that in 2014 established a PFAC, the Beneficiary Advisory Council. Approach: Using grounded theory, we analysed field notes, analytic memos and transcripts to develop a theoretical model of patient engagement via PFACs. Results: Forty-two patients and caregivers participated in five focus groups that included individuals of different ages, races, health statuses and socio-economic statuses. Participants were largely unaware of PFACs. Participants wanted to know who represented them (interpreted as a form of political representation) and emphasized the need for representatives' diversity. Who mattered because who could affect what PFACs do. Participants expected that all patients should be able to communicate with PFACs and that meaningful engagement could enhance perceptions of health systems.Conclusions: Eliciting views about patient representation from patients who have not been engaged as advisors or representatives has the potential to inform PFACs' activities. Attention should be given to improving and measuring patients' awareness of, and interactions with, their patient representatives. | 149DUKHANIN et Al.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Who represents me? A patient‐derived model of patient engagement via patient and family advisory councils (PFACs)

Dukhanin

Feeser

Berkowitz

et al. 2019

Health Expectations

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“…In our research, few patients knew they had representatives, and even fewer knew how to contact them; at the same time, nearly all thought they deserved to know and to interact with them. 22 Similarly, in community-based work, grassroots representatives are ready to serve in formal roles of advising and partnering with healthcare systems and researchers but are rarely invited to engage with their local institutions. The expansion of engagement activities to connect representatives to those whom they represent can take different forms.…”

Section: An Alternative: From Consucrat To Representativementioning

confidence: 99%

Patient, Public, Consumer, and Community Engagement: From Consucrat to Representative Comment on "The Rise of the Consucrat"

DeCamp

Brewer

Dukhanin

2020

Int J Health Policy Manag

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Patient, public, consumer, and community (P2C2) engagement in healthcare delivery, research, and policy-making has been long considered an ethical obligation and is increasingly a regulatory requirement globally. The requirement to include a P2C2 member on various governing bodies may have inadvertently created what Evelyne de Leeuw calls the "consucrat" – a career consumer who has been designated and professionalized to function on behalf of a particular group or community. The concept of a consucrat can be problematic when a P2C2 member is co-opted by an institution governing body or in situations where institutions only seek and listen to the same voice over time. In this commentary, we suggest that one way to avoid these problems is to take seriously the concept and process of representation. Representation is only meaningful when P2C2 members are actively connected with those whom they represent. Doing so helps ensure P2C2 members remain grounded in the real-world concerns of their constituency and that representatives, backed by the voices of others, will be more powerful in effecting change.

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“…In the past, the importance of the patient-physician relationship did not get much attention from health care decision makers [15][16][17]. Today, however, health care services and physicians perceive and refer to this relationship as a strategic marketing tool for three main reasons.…”

Section: Introductionmentioning

confidence: 99%

The patient–physician relationship: an account of the physician’s perspective

Berger

Bulmash

Drori

et al. 2020

Isr J Health Policy Res

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Background: The issue of patient-physician relationships in general, and particularly the trust of patients in their primary care physician has gained much interest in academia and with practitioners in recent years. Most research on this important topic, however, focused on how patients view the relationship and not how the physicians see it. This research strives to bridge this gap, with the resolution of leading to an improved appreciation of this multifaceted relationship. Methods: A survey of 328 actively practicing physicians from all four health maintenance organizations (HMOs) in Israel resulted in a hierarchical formation of components, indicating both the relative as well as absolute importance of each component in the formation of the patient-physician relationship. The sample conducted was a convenience one. Methodologically, we used two different complementary methods of analysis, with the primary emphasis on the Analytic Hierarchical Processing (AHP), a unique and advanced statistical method. Results: The results provide a detailed picture of physicians' attitudes toward the patient-physician relationship. Research indicates that physicians tend to consider the relationship with the patient in a rather pragmatic manner. To date, this attitude was mostly referred to intuitively, without the required rigorous investigation provided by this paper. Specifically, the results indicate that physicians tend to consider the relationship with the patient in a rather pragmatic manner. Namely, while fairness, reliability, devotion, and serviceability received high scores from physicians, social interaction, friendship, familial, as well as appreciation received the lowest scores, indicating low priority for warmth and sociability in the trust relationship from the physician's perspective. The results showed good consistency between the AHP results and the ANOVA comparable analyses. Conclusions: In contrast to patients who traditionally stress the importance of interpersonal skills, physicians stress the significance of the technical expertise and knowledge of health providers, emphasizing the role of competence and performance. Physicians evaluate the relationship on the basis of their ability to solve problems through devotion, serviceability, reliability, and trustworthiness and disregard the "softer" interpersonal aspects such as caring, appreciation, and empathy that have been found to be important to their patients. This illustrates a mismatch in the important components of relationship building that can lead to a loss of trust, satisfaction, and repeat purchase.

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Patients’ Views About Patient Engagement and Representation in Healthcare Governance

Cited by 11 publications

References 22 publications

Who represents me? A patient‐derived model of patient engagement via patient and family advisory councils (PFACs)

Who represents me? A patient‐derived model of patient engagement via patient and family advisory councils (PFACs)

Patient, Public, Consumer, and Community Engagement: From Consucrat to Representative Comment on "The Rise of the Consucrat"

The patient–physician relationship: an account of the physician’s perspective

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