Abstract
BackgroundPatient engagement (PE) in planning or improving hospital facilities or services is one approach for improving healthcare delivery and outcomes. To provide evidence on hospital capacity needed to support PE, we described the attributes of hospital PE capacity associated with clinical quality measures.MethodsWe conducted a cross-sectional survey of general and specialty hospitals based on the Measuring Organizational Readiness for Patient Engagement framework. We derived a PE capacity index measure, and with Multiple Correspondence Analysis, assessed the association of PE capacity with hospital type, and rates of hand-washing, C. difficile infection rates and 30-day readmission.ResultsRespondents (91, 66.4%) included general: < 100 beds (48.4%), 100+ beds (27.5%), teaching hospitals (11.0%) and specialty (13.2%) hospitals. Most featured PE in multiple clinical and corporate departments. Most employed PE in a range of Planning (design/improve facilities 94.5%, develop strategic plans 87.9%), Evaluation/Quality Improvement (accreditation 91.2%, develop QI plans 90.1%) and Service Delivery activities (develop information/communication aids 92.3%). Hospitals enabled PE with multiple supports (median 12, range 0 to 25), most often: 76.9% strategic plan recognizes PE, 74.7% patient/family advisory council, and 69.2% pool of patient volunteers; and least often: 30.0% PE staff, 26.4% PE funding and 16.5% patient reimbursement or 3.3% compensation. Hospitals employed a range of less (inform, consult) and more (involve, partner) active modes of engagement. Two variables accounted for 29.6% of variance in hospital PE capacity index measure data: number of departments featuring PE and greater use of active engagement modes. PE capacity was not associated with general hospital type or clinical quality measures.ConclusionsHospitals with fewer resources can establish favourable PE conditions by deploying PE widely and actively engaging patients. Healthcare policy-makers, hospital executives and PE managers can use these findings to allocate PE resources. Future research should explore how PE modes and methods impact clinical outcomes.
Highlights
Hospitals, which provide a considerable proportion of any country’s healthcare services, strive to improve patient experiences and outcomes
Organizational capacity for Patient engagement (PE) and hospital type Two variables accounted for 29.6% of variance in data for the index measure of hospital PE capacity: number of departments featuring PE and higher proportion of more active engagement modes
Our survey of 91 general and specialty hospitals revealed that most hospitals engaged patients in planning, evaluation/quality improvement and service delivery using both more and less active modes of engagement across multiple clinical and corporate departments
Summary
Hospitals, which provide a considerable proportion of any country’s healthcare services, strive to improve patient experiences and outcomes. Across 27 countries, a median of 10% of hospital patients experienced at least one adverse event, largely stemming from surgical procedures, medication/fluids, and healthcareassociated infections, with a median of 51.2% considered preventable [2]. Hospital experiences, including adverse events, can negatively influence patient ratings of hospital, physician and nursing care [3]. The proportion of patients who gave high overall ratings of their hospital ranged from 35 to 60% across 13 countries [4]. There is a need to further improve hospital patient experiences and care. Patient engagement (PE) in planning or improving hospital facilities or services is one approach for improving healthcare delivery and outcomes. To provide evidence on hospital capacity needed to support PE, we described the attributes of hospital PE capacity associated with clinical quality measures
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