Kohler, G., Sampalli, T., Ryer, A., Porter, J., Wood, L., Bedford, L., Higgins-Bowser, I., Edwards, L., Christian, E., Dunn, S., Gibson, R., Ryan Carson, S., Vallis, M., Zed, J., Tugwell, B., Van Zoost, C., Canfield, C., Rivoire, E. (2017). Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes. International Journal of Health Policy and Management, 6(11), 661-668. doi: 10.15171/ijhpm.2017.27
Graeme Kohler; Tara Sampalli; Ashley Ryer; Judy Porter; Les Wood; Lisa Bedford; Irene Higgins-Bowser; Lynn Edwards; Erin Christian; Susan Dunn; Rick Gibson; Shannon Ryan Carson; Michael Vallis; Joanna Zed; Barna Tugwell; Colin Van Zoost; Carolyn Canfield; Eleanor Rivoire. "Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes". International Journal of Health Policy and Management, 6, 11, 2017, 661-668. doi: 10.15171/ijhpm.2017.27
Kohler, G., Sampalli, T., Ryer, A., Porter, J., Wood, L., Bedford, L., Higgins-Bowser, I., Edwards, L., Christian, E., Dunn, S., Gibson, R., Ryan Carson, S., Vallis, M., Zed, J., Tugwell, B., Van Zoost, C., Canfield, C., Rivoire, E. (2017). 'Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes', International Journal of Health Policy and Management, 6(11), pp. 661-668. doi: 10.15171/ijhpm.2017.27
Kohler, G., Sampalli, T., Ryer, A., Porter, J., Wood, L., Bedford, L., Higgins-Bowser, I., Edwards, L., Christian, E., Dunn, S., Gibson, R., Ryan Carson, S., Vallis, M., Zed, J., Tugwell, B., Van Zoost, C., Canfield, C., Rivoire, E. Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes. International Journal of Health Policy and Management, 2017; 6(11): 661-668. doi: 10.15171/ijhpm.2017.27
Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes
1Primary Health Care, Nova Scotia Health Authority, Halifax, NS, Canada
2Diabetes Management Centre, Primary Health Care, Nova Scotia Health Authority, Halifax, NS, Canada
3Public Engagement, Nova Scotia Health Authority, Halifax, NS, Canada
4Behaviour Change Institute, Primary Health Care, Nova Scotia Health Authority, Halifax, NS, Canada
5Dalhousie Family Medicine, Halifax, NS, Canada
6Endocrinology, Nova Scotia Health Authority, Halifax, NS, Canada
7General Internal Medicine, Nova Scotia Health Authority, Halifax, NS, Canada
8Canadian Foundation Healthcare Improvement, Ottawa, ON, Canada
Abstract
Background Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice.
Methods The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach.
Results The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide.
Conclusion This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability.
Loehrer S, Lewis N, Bogan M. Improving the health of populations: a common language is key. Healthc Exec. 2016;31(2):82-83.
Coulter A, Ellins J. Effectiveness of strategies for informing, educating and involving patients. BMJ. 2007;335(7609):24–27. doi:10.1136/bmj.39246.581169.80
Bieber C, Müller KG, Blumenstiel K, Schneider A, Richter A, Wilke S. Long-term effects of a shared decision-making intervention on physician–patient interaction and outcome in fibromyalgia. A qualitative and quantitative follow-up of a randomized controlled trial. Patient Educ Couns. 2006;63(3):357-366.
Carman K, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff. 2013;32(2):223-231. doi:10.1377/hlthaff.2012.1133
Epstein R, Street R. The Values and Value of Patient-Centered Care. Ann Fam Med. 2011;9 (2):100-103. doi:10.1370/afm.1239
Flynn K, Smith M, Vanness D. A Typology of Preferences for Participation in Healthcare Decision-Making. Soc Sci Med. 2006;63(5):1158-1169. doi:10.1016/j.socscimed.2006.03.030
Gallivan J, Burns K, Bellows M, Eigenseher C. The many faces of patient engagement. J Participat Med. 2012;26(4):32.
Chewning B, Bylund C, Shah B, Arora NG, Makoul G. Patient Preferences for Shared Decisions: A Systematic Review. Patient Educ Couns. 2012;86(1):9-18. Doi:10.1016/j.pec.2011.02.004
Ridd M, Shaw A, Lewis G, Salisbury C. The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives. Br J Gen Pract. 2009;59(561):116-133. doi:10.3399/bjgp09X420248
Hibbard J, Greene J, Tusler M. Improving the outcomes of disease management by tailoring care to the patient's level of activation. Am J Manag Care. 2009;15(6):353-360.
Barr V, Robinson S, Marin-Link B, et al. The expanded chronic care model: An integration of concepts and strategies from population health promotion and the chronic care model. Hosp Q. 2003;7(1):73-82. doi:10.12927/hcq.2003.16763
Tsianakas V, Robert G, Maben J, Richardson A, Dale C, Wiseman T. Implementing patient centred cancer care: using experience-based co-design to improve patient experience in breast and lung cancer services. J Support Care Cancer. 2012;20:2639-2647.
Burns K, Bellows M, Eigenseher C, Gallivan J. 'Practical' resources to support patient and family engagement in healthcare decisions: a scoping review. BMC Health Ser Res. 2014;14:175. doi:10.1186/1472-6963-14-175
Health Council of Canada. Turning What We know into Action: A Commentary on the National Symposium on Patient Engagement. Health Council of Canada; 2012. http://www.healthcouncilcanada.ca/dl_check.php?id=321&tp=1. Accessed June 30, 2015.
Elwyn G, Laitner S, Coulter A, Walker E, Watson P, Thompson R. Implementing shared decision-making in the NHS. BMJ. 2010;341:5146. doi:10.1136/bmj.c5146.
McMurchy D. What are the critical attributes and benefits of a high-quality primary health care system? Ottawa, ON: Canadian Health Services Research Foundation; 2009. http://patientfamilyengagement.org/roadmap.php. Accessed July 5, 2015.
Fondrick M, Johnson B. Creating Patient and Family Advisory Councils. Institute for Patient and Family Centered Care website. http://www.ipfcc.org/advance/Advisory_Councils.pdf. Accessed March 6, 2015.
Lewis S. Patient-centered care: an introduction to what it is and how to achieve it. Saskatchewan Ministry of Health; 2009.
Sidani S. Effects of patient-centered care on patient outcomes: an evaluation. Res Theory Nurs Pract. 2008;22(1):24-37.
Hudon C, Fortin M, Haggerty J, Lambert M, Poitras M. Measuring patients' perceptions of patient-centered care: a systematic review of tools for family medicine. Ann Fam Med. 2011;9(2).155-164. doi:10.1370/afm.1226.
Top