I can’t remember who said it first, and it’s been said many times now, patients and families are the most underutilized patient safety resource in health care today. Health care organizations are always looking for tools and resources to provide patient-centered, safe, high-quality care and the best resources are abundantly available right in front of us. Patients and families are the only constant across the care continuum. They see and experience the good, the bad and the ugly in our health care system. So why not invite them to help us improve?
The National Patient Safety Foundation noted that “growing research shows that patients who are more involved with their care have better experiences in the health care system and often, better outcomes. Patients and family members can play a role in preventing avoidable harm.” I contend that patients and families not only can play a role in preventing avoidable harm, but in order to make transformational change, they must play a prominent role.
Recently, we hosted a panel of patient advisors on a webinar who discussed their partnership with their local hospital. These are incredible individuals who have taken their extensive experience with the health care system--some good, some not so good--and put it to use to help their hospital improve.
For example, a patient from Michigan Medicine (formerly University of Michigan Health System), who utilizes their services between 50 and 100 times per year, has partnered with them in many ways. Most recently she has become a facilitator for their new patient and family- centered care curriculum for the medical school and serves as a mentor for first-year medical students. The medical students interact with her on their first day and throughout the year, visiting her in her home and attending a medical appointment with her. This sets the foundation for these future physicians that patients not only must be partners in their care to get the best outcomes possible, but they also need to participate in improving health care systemically.
Being a patient advisor has allowed her to use her voice, as a patient and caregiver, to assist Michigan Medicine in making improvements for all patients and families. This sentiment is shared by every patient advisor I have ever spoken to, including one from Vidant Edgecombe Hospital who also participated in our panel discussion. She has built a unique partnership with the hospital’s emergency department (ED). She volunteers in the ED--on her schedule--not on a schedule set by the hospital. When she arrives, she greets the staff and begins her work. She knocks on the doors of patient rooms and asks how they are doing and if they fully understand the care they are receiving. She helps with everything from getting extra pillows and blankets to alerting medical staff to patient’s pain levels or other critical issues.
On one particular busy evening, she rounded on patients in the waiting room. She helped explain the longer-than-normal wait times and implored those waiting for care to sit tight, the staff were doing everything they could to get them in to see the doctor. She successfully convinced three patients to stay, only losing one patient to the long wait; which she took as a personal defeat because of her caring nature and quest to help the ED provide the best care possible for their small community.
There are countless other examples of patient advisors helping hospitals, academic institutions and other health care organizations improve. They help improve not just the patient experience of care, but the safety and quality of care provided by the organization. The Agency for Healthcare Research and Quality (AHRQ) understands this.
The AHRQ’s Guide to Patient and Family Engagement in Hospital Quality and Safety provides a step-by-step approach to create these types of relationships, specifically through advisory councils. The AHRQ has a multitude of tools and resources, many of which have been created with patient and family input, to engage and effectively communicate with patients. One of their newest tools is a Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families which targets four specific interventions. The Agency's partners for this work include Project Patient Care, Consumers for Advancing Patient Safety and MedStar Health, all of which are long-term partners with Vizient in our PFE work as well.
I encourage you to examine the ways in which your organization engages patients and families in your improvement activities. Be creative! The extent to which patients and families can help your organization improve is only limited by your thinking.
About the author. In her current role as director, HIIN and TCPI Delivery, Kellie Goodson leads performance improvement networks on the topics of culture/leadership/high reliability, patient and family engagement, and health equity that provide cross-cutting strategies to reduce patient harm in member health care organizations, in partnership with patient safety experts and advocates.