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Increasing Capacity for Meaningful
Engagement
Patient Engagement Projects (PEP)
• CHSRF’s overall intent:
  – Uncover and disseminate lessons learned and promising
    practices leading to care that is truly patient-centred.
• Key objectives:
  – Support the development, implementation and evaluation of patient
    engagement interventions for health services whose goal is to
    improve the quality of patient-centred care services
  – Enhance organizations’ capacity to engage patients in the design,
    delivery and evaluation of healthcare
  – Increase knowledge of promising patient engagement strategies that
    ensure patients are at the core of health services, and about how and
    why such strategies may be effective
“Researchers rely on health
system managers,
policymakers and their
organizations to provide the
„laboratories‟ for their public
engagement evaluation work.
In return, managers and
policy-makers are in a position
to gain the expertise and tools
needed to improve their public
engagement practice and to
measure its benefits. We call
for the development of
innovative research-practice
partnerships throughout the
country that would promote
this type of learning.”

      Available at:
      www.chsrf.ca
The Continuum of Patient Engagement
 Patient engagement is more than patient-
 centred care, it is the involvement of patients in
 the design of care, including participation in
 improvement projects




                                      Bate and Robert, 2006
Funded Projects       • 5 province-wide initiatives
                        (including 2 cancer related
                        projects)
                      • 4 mental health initiatives
 = PEP 2010           • 2 acute care settings
 = PEP 2011           • 2 regional health authorities
                      • 2 rehabilitation centres
                      • 2 community care centres




                  5
Accompanying Research
                                         3. Interviews
    1. Literature
                                              with
       Review
                                            Experts

                         Inform

     2. Web 2.0                             4. Case
    Engagement                               Studies
     Strategies                          of Innovative
                                           Practices



              5. Qualitative Analysis of the
                       PEP Teams
PEP research team: A. MacIntosh-Murray, 2011 (mapping 2010 PEP teams on continuum)
The Practice-Evaluation Gap


  “There is a striking imbalance between the amount of time,
 money and energy that governments in OECD countries invest in
 engaging citizens and civil society in public decision making and
the amount of attention they pay to evaluating the effectiveness
                   and impact of such efforts.”
                                                                (OECD, 2005)




                     Reference: Organisation for Economic Co-Operation
                     and Development. Evaluating Public Participation in
                     Policy Making. Paris: OECD Publications, 2005.
Sample Patient Engagement (PE) Indicators*
                • Organizations develop decision-making structures and processes (plans) for
   Patient        patient involvement
Engagement      • Patients identify areas of improvement and provide input/recommendations
                • Evidence of structures and processes to respond to patient input
 Indicators     • Higher quality care resulting from PE
                • Patient engagement practices spread to other organizations

                                 PEP Project Reporting Requirements
   Project      • How has the intervention changed systems, internally or externally or
                  affected practices?
  Reporting     • What’s being done to sustain those changes?
Requirements    • What factors helped or hindered the success of the interventions?
                • How could the lessons learned from the intervention be applied to other
                  issues in your organization and beyond?

                                   CHSRF Decision-maker Indicators
                • Decision-maker’s (DM) respond to CHSRF funding opportunities
CHSRF-wide      • DM’s attend learning events
 Indicators     • Funded DM’s put in place structures and processes to better engage patients
                  through intervention projects
                • Evidence of management practice change in a direct organization
                • Evidence of management practice change in an indirect organization

               *Adapted from Abelson, J. (May 13, 2011). Presentation to PEP I teams:
               “Evaluating Public Engagement: Concepts, Methods and Challenges”.
               Toronto, ON.
Patient Engagement as a Lever for
Transformation
• CHSRF has commissioned a series of policy-relevant
  syntheses of the evidence on key levers for health
  system transformation.
• At least two of these identify patient/public
  engagement as levers for transformation:
   – Jean-Louis Denis, “Assessing initiatives to transform
     healthcare systems: lessons for the Canadian healthcare
     system”, May 2011.
   – Ross Baker and Jean-Louis Denis, “A Comparative Study of
     Three Transformative Healthcare Systems: Lessons for
     Canada”, Fall 2011.
Key Elements Across the 3 Systems
• Quality and system improvement as a core strategy
• Developing organizational capabilities and skills to
  support improvement
• Robust primary care teams at the centre of the
  delivery system
• Engaging patients in their care and in the design of
  care
• Promoting professional cultures that support
  teamwork, continuous improvement and patient
  engagement
                 Presented by Ross Baker and Jean-Louis Denis, “CHSRF Policy
                 Dialogue on Healthcare Transformation in Western and Northern
                 Canada: Leveraging Patient Experience”, Edmonton, September 16th,
                 2011.
Key Elements (2)
• More effective integration of care that promotes
  seamless care transitions
• Information as a platform for guiding improvement
• Effective learning strategies and methods to test and
  scale up improvements
• Leadership activities that embrace common goals
  and align activities throughout the organization
• Providing an enabling environment buffering short-
  term factors that undermine success
Patient Engagement Processes
                                  Enlisting and
                               Preparing Patients




 Asserting patient
experience as a key                                          Communicating patient
   value and goal                                             experiences to staff


                  Ensuring
                                                    Engaging staff to
             leadership support
                                                    involve patients
             and strategic focus


                       Ross Baker and Jean-Louis Denis, “CHSRF Policy Dialogue on
                       Healthcare Transformation in Western and Northern Canada:
                       Leveraging Patient Experience”, Edmonton, September 16th, 2011.
Preliminary Conclusions
• Patient engagement is potentially a powerful
  lever to align a system toward change and
  improvement
• Patient engagement initiatives should be linked to
  “must do priorities” in health system and
  organizations
• Strong leadership at the political, strategic and
  operational levels is needed to maximize benefits
  and sustain commitment to patient engagement
For more information, please
           contact:
Mireille.Brosseau@chsrf.ca
 Program Lead, Patient and
    Citizen Engagement

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Increasing Capacity for Meaningful Engagement

  • 1. Increasing Capacity for Meaningful Engagement
  • 2. Patient Engagement Projects (PEP) • CHSRF’s overall intent: – Uncover and disseminate lessons learned and promising practices leading to care that is truly patient-centred. • Key objectives: – Support the development, implementation and evaluation of patient engagement interventions for health services whose goal is to improve the quality of patient-centred care services – Enhance organizations’ capacity to engage patients in the design, delivery and evaluation of healthcare – Increase knowledge of promising patient engagement strategies that ensure patients are at the core of health services, and about how and why such strategies may be effective
  • 3. “Researchers rely on health system managers, policymakers and their organizations to provide the „laboratories‟ for their public engagement evaluation work. In return, managers and policy-makers are in a position to gain the expertise and tools needed to improve their public engagement practice and to measure its benefits. We call for the development of innovative research-practice partnerships throughout the country that would promote this type of learning.” Available at: www.chsrf.ca
  • 4. The Continuum of Patient Engagement Patient engagement is more than patient- centred care, it is the involvement of patients in the design of care, including participation in improvement projects Bate and Robert, 2006
  • 5. Funded Projects • 5 province-wide initiatives (including 2 cancer related projects) • 4 mental health initiatives = PEP 2010 • 2 acute care settings = PEP 2011 • 2 regional health authorities • 2 rehabilitation centres • 2 community care centres 5
  • 6. Accompanying Research 3. Interviews 1. Literature with Review Experts Inform 2. Web 2.0 4. Case Engagement Studies Strategies of Innovative Practices 5. Qualitative Analysis of the PEP Teams
  • 7. PEP research team: A. MacIntosh-Murray, 2011 (mapping 2010 PEP teams on continuum)
  • 8. The Practice-Evaluation Gap “There is a striking imbalance between the amount of time, money and energy that governments in OECD countries invest in engaging citizens and civil society in public decision making and the amount of attention they pay to evaluating the effectiveness and impact of such efforts.” (OECD, 2005) Reference: Organisation for Economic Co-Operation and Development. Evaluating Public Participation in Policy Making. Paris: OECD Publications, 2005.
  • 9. Sample Patient Engagement (PE) Indicators* • Organizations develop decision-making structures and processes (plans) for Patient patient involvement Engagement • Patients identify areas of improvement and provide input/recommendations • Evidence of structures and processes to respond to patient input Indicators • Higher quality care resulting from PE • Patient engagement practices spread to other organizations PEP Project Reporting Requirements Project • How has the intervention changed systems, internally or externally or affected practices? Reporting • What’s being done to sustain those changes? Requirements • What factors helped or hindered the success of the interventions? • How could the lessons learned from the intervention be applied to other issues in your organization and beyond? CHSRF Decision-maker Indicators • Decision-maker’s (DM) respond to CHSRF funding opportunities CHSRF-wide • DM’s attend learning events Indicators • Funded DM’s put in place structures and processes to better engage patients through intervention projects • Evidence of management practice change in a direct organization • Evidence of management practice change in an indirect organization *Adapted from Abelson, J. (May 13, 2011). Presentation to PEP I teams: “Evaluating Public Engagement: Concepts, Methods and Challenges”. Toronto, ON.
  • 10. Patient Engagement as a Lever for Transformation • CHSRF has commissioned a series of policy-relevant syntheses of the evidence on key levers for health system transformation. • At least two of these identify patient/public engagement as levers for transformation: – Jean-Louis Denis, “Assessing initiatives to transform healthcare systems: lessons for the Canadian healthcare system”, May 2011. – Ross Baker and Jean-Louis Denis, “A Comparative Study of Three Transformative Healthcare Systems: Lessons for Canada”, Fall 2011.
  • 11. Key Elements Across the 3 Systems • Quality and system improvement as a core strategy • Developing organizational capabilities and skills to support improvement • Robust primary care teams at the centre of the delivery system • Engaging patients in their care and in the design of care • Promoting professional cultures that support teamwork, continuous improvement and patient engagement Presented by Ross Baker and Jean-Louis Denis, “CHSRF Policy Dialogue on Healthcare Transformation in Western and Northern Canada: Leveraging Patient Experience”, Edmonton, September 16th, 2011.
  • 12. Key Elements (2) • More effective integration of care that promotes seamless care transitions • Information as a platform for guiding improvement • Effective learning strategies and methods to test and scale up improvements • Leadership activities that embrace common goals and align activities throughout the organization • Providing an enabling environment buffering short- term factors that undermine success
  • 13. Patient Engagement Processes Enlisting and Preparing Patients Asserting patient experience as a key Communicating patient value and goal experiences to staff Ensuring Engaging staff to leadership support involve patients and strategic focus Ross Baker and Jean-Louis Denis, “CHSRF Policy Dialogue on Healthcare Transformation in Western and Northern Canada: Leveraging Patient Experience”, Edmonton, September 16th, 2011.
  • 14. Preliminary Conclusions • Patient engagement is potentially a powerful lever to align a system toward change and improvement • Patient engagement initiatives should be linked to “must do priorities” in health system and organizations • Strong leadership at the political, strategic and operational levels is needed to maximize benefits and sustain commitment to patient engagement
  • 15. For more information, please contact: Mireille.Brosseau@chsrf.ca Program Lead, Patient and Citizen Engagement