Barriers to patient involvement in health service planning and evaluation: An exploratory study (original) (raw)
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Research Square (Research Square), 2023
Background Strategies aimed at promoting patient involvement vary in purpose across different healthcare settings and are assessed using a wide range of outcomes. However, there is no consensus on the most appropriate measurement tools or ways to evaluate patient involvement initiatives. This qualitative study aimed to explore the perspectives of stakeholders from micro, meso, and macro levels within the Danish healthcare system on patient involvement and its measurement. MethodsThis descriptive, explorative study employed semi-structured interviews with open-ended questions to elicit participants' views and experiences of patient involvement and measurement tools. A purposeful sample of participants was identi ed, to include decision makers, researchers, and health professionals (n=20) with experiences of patient involvement in healthcare at micro, meso, and macro levels across Danish organizations. Data underwent re exive thematic analysis. Results Three main themes were identi ed: 1) Determining the purpose of patient involvement and measurement alignment; 2) Re ecting on the qualities, t, and usefulness of measures; 3) Recognizing con icting stakeholder paradigms. Despite the interest in and positive attitudes toward patient involvement, views on the meaning and value of evaluating involvement and innovating varied; in part, this was attributable to challenges in selecting criteria, methods, and measures for evaluation. Conclusion The ndings indicate the need to integrate the perspectives of all key stakeholders in designing the evaluation of patient involvement initiatives. The application of a multiple stakeholder approach and co-production of a multidimensional evaluation may provide some common ground for selecting evaluation criteria and measurement tools in the healthcare setting.
Exploring the evidence base of patient involvement in the management of health care services
Journal of Nursing Management, 2008
Exploring the evidence base of patient involvement in the management of health care services Aim This paper aims to explore the evidence base of patient involvement in the management of health care services. Background It has been suggested that, as well as acknowledging the role that service users could play in deciding their own treatment, they should also be involved in the managerial aspects of health service delivery. However, there is no robust evidence base to support user involvement either in terms of patient preference or in terms of improved service outcomes. Methods Seven databases were searched using the search terms Ôuser involvementÕ and Ôservice managementÕ. Terms were adjusted for each database to maximize the number of hits. Each paper was graded using the sophisticated typology developed by the UK Department of Health. Results Four key issues emerged surrounding organizational power, shared meaning, liaison and user contribution. Conclusions There is a reasonable body of robust qualitative evidence surrounding user involvement in health service management but a disappointing lack of quantitative studies or mixed methods approaches. Implications for nursing management Using the emergent messages will assist service mangers in enhancing user/provider collaborations.
“Patient participation” and related concepts: A scoping review on their dimensional composition
Patient Education and Counseling, 2019
Objectives Several concepts on collaboration between patients and healthcare systems have emerged in the literature but there is little consensus on their meanings and differences. In this study, "patient participation" and related concepts were studied by focusing on the dimensions that compose them. This review follows two objectives: (1) to produce a detailed and comprehensive overview of the "patient participation" dimensions; (2) to identify differences and similarities between the related concepts. Methods A scoping review was performed to synthesize knowledge into a conceptual framework. An electronic protocol driven search was conducted in two bibliographic databases and a thematic analysis was used to analyse the data. Results The search process returned 39 articles after exclusion for full data extraction and analysis. Through the thematic analysis, the dimensions, influencing factors and expected outcomes of "patient participation" were determined. Finally, differences between the included concepts were identified. Conclusion This global vision of "patient participation" allows us to go beyond the distinctions between the existing concepts and reveals their common goal to include the patient in the healthcare system. Practice implications This scoping review provides useful information to propose a conceptual model of "patient participation", which could impact clinical practice and medical training programs.
Meaningful and effective patient engagement: What matters most to stakeholders
Patient Experience Journal
To determine what resources, preparation, and support are needed for patients, providers, and leaders to meaningfully and appropriately engage in patient-centred health system redesign, researchers sought stakeholder groups. A qualitative descriptive design was selected using purposive participant samp 'what' and 'why' questions pertaining to stakeholder perceptions about patient engagemen patients, providers or leaders. Four project groups were selected; each group was responsible for a strategic initiative with Alberta Health Services and represented one of three different levels of the healthcare system (i governance). Semi-structured question guides were used to collect data. Thematic analysis of the transcribed participant responses revealed eleven major themes: and timing of engagement; recruitment and commitment; governance and structure; kno importance of communication around the reasons for patient engagement including building trust through collaboration clearly identifying goals, along with their roles and responsibilities. development of tools, resources and education materials required to support patient engagement activities tailored to the needs, understandings and perspectives of stakeholders.
Patient Participation in Service Improvement of Primary Care Services
RAHIS
Healthcare services from western economies use patient and public participation to promote quality improvement. In Brazil, community participation is a guideline for the public healthcare system. However, community participation is little developed and few efforts are made to improve it. Through a case study, we described and analyze the service improvement process used in SUS primary care units of Florianopolis and the community involvement in this process. Semi-structured interviews with healthcare professionals, and community representatives were conducted. Results show that improvements are made in local improvements or in an annual planning process, and the community participation in them is low. The annual planning process have deficiencies in its methodology and conduction. The adoption of co-creative methods can improve community participation on SUS and strengthen its participation policy. These methods can also help better structure improvement processes.
Purpose:Patient and public involvement has long been recognised as a cornerstone of clinical governance but the evidence-based evaluation of the progress and effectiveness of patient and public involvement in healthcare are limited. This study aimed to use available evidence and expert consensus to develop performance indicators of patient and public involvement in hospital. Methods:A three-step process was used to develop the indicators. Firstly, key indicators and recommendations were identified from the literature and distributed over 5 domains: customer satisfaction, compliance management, customer orientation, voice of customer and patients' right. A multidisciplinary panel of medical professionals (n=8) rated and prioritized the indicators via two-round Delphi technique. Subsequently, the panel assessed the indicators at two consensus meetings. Results:Of the 41 draft performance indicators, the expert panel members achieved positive consensus on 33 indicators. Also 2 indicators were developed on experts' opinions. Conclusion:About 35 patient and public participation performance indicators were identified.Evidence support was available for most indicators. The set of indicators provide a baseline for patient and public involvement among stakeholders enabling them to evaluate and improve their accountability.
Optimizing patient involvement in quality improvement
Health Expectations, 2013
Introduction Patient and public involvement in healthcare planning, service development and health-related research has received significant attention. However, evidence about the role of patient involvement in quality improvement work is more limited. We aimed to characterize patient involvement in three improvement projects and to identify strengths and weaknesses of contrasting approaches.
Understanding patient engagement in health system decision-making: a co-designed scoping review
Systematic Reviews, 2019
Background: With healthcare striving to shift to a more person-centered delivery model, patient and family involvement must have a bigger role in shaping this. While many initiatives involving patients and family members focus on self-care, a broader understanding of patient participation is necessary. Ensuring a viable and sustainable critical number of qualified patients and family members to support this shift will be of utmost importance. The purpose of this study was to understand how health systems are intentionally investing in the training and skill development of patients and family members. Methods: Patient co-investigators and researchers conducted a scoping review of the existing literature on methods adopted by healthcare systems to build the skills and capacity of patients to participate in healthcare decision-making using a recognized methodological framework. Six electronic databases were searched to identify studies. Two independent reviewers screened titles and abstracts and full-text papers for inclusion. The research team independently extracted data. Any disagreements were resolved by achieving consensus through discussion. Quantitative and qualitative content synthesis, as well as a quality assessment, was conducted. Results: After eliminating duplicates, the search resulted in 9428 abstracts. Four hundred fifty-eight articles were reviewed and 15 articles were included. Four themes emerged: forums (33%), patient instructors (20%), workshops (33%), and co-design (13%). Four of the identified studies measured the impact and overall effectiveness of the respective programs. Examples of how patient and family members were supported (invested in) included advocacy training to support future involvement in engagement activities, a training program to conduct patient-led research, involvement in an immersive experience-based co-design initiative, and involvement in training pharmacy students. Overall, these studies found positive outcomes when patients and family members were recipients of these opportunities. Conclusions: The results of this scoping review demonstrate that an evidence base around programs to advance patient engagement is largely absent. An opportunity exists for further research to identify strategies and measures to support patient engagement in healthcare decision-making.