Engagement in Health
One of the series of reports that the Agency for Healthcare Research and Quality publishes is designed to provide useful information for patients and consumers of health care. One of the intended products is a guide for patient and family engagement in regard to hospital care, particularly safety and quality. The underlying premise is that patients and families can play an important role in avoiding errors and improving safety in the hospital setting. The evidence scan which lays the foundation for the guide itself has been published. (AHRQ Report) The report was compiled through a survey of research literature, tools, websites and through interviews with experts. Three main areas are reported on: individual characteristics and needs of the target audience; organization contexts in hospitals that influence engagement; and hospital interventions and materials that facilitate engagement.
A summary of the evidence scan is that patients and providers tend to think the quality of care is good; providers focus on clinical outcomes and patients focus on interpersonal interactions. Patients tend to view safety solely as a matter of medical errors; providers tend to see errors as the fault of individuals and to de-emphasize system wide changes. Both patients and providers say they value patient engagement but not much is actually done to encourage it. Patients are most likely to be comfortable asking for information and not comfortable with asking providers to do certain things, like wash their hands. Barriers to engagement include fear, low health literacy and concern about provider reaction for patients; and for providers, include fear of litigation and effort. Their are some tools available to help individuals and hospitals encourage engagement, but there is little to no evidence about the effectiveness of these tools or what would be the best way to raise levels of engagement.