Patient Involvement In Quality Improvement Research Articles

Patient involvement in quality improvement: a survey comparing naturalistic and reflective approaches

BackgroundThis study investigates reflective and naturalistic approaches to patient involvement in quality improvement. The reflective approach, using, for example, interviews, provides insights into patient needs and demands to support an...

‘We are data rich but information poor’: how do patient-reported measures stimulate patient involvement in quality improvement interventions in Swedish hospital departments?

ObjectiveThis study aimed to investigate if and how patient-reported measures from national and local monitoring stimulate patient involvement in hospital quality improvement (QI) interventions. We were also interested in the...

Exploring power shifts as an enabler for a strengthened patient role in quality improvements: a Swedish survey study

ObjectivesThis study examined the relationship between professionals’ perceptions of a strengthened role for the patient and of patient involvement in quality improvement (QI) and whether professionals’ experiences in improvement science...

Patient involvement in quality improvement \u2013 a \u2018tug of war\u2019 or a dialogue in a learning process to improve healthcare?

BackgroundCo-production and co-design approaches to quality improvement (QI) efforts are gaining momentum in healthcare. Yet, these approaches can be challenging, not least when it comes to patient involvement. The aim of this study was to examine what might influence QI efforts in which patients are involved, as experienced by the patients and the healthcare professionals involved.MethodsThis study involved a qualitative design inspired by the constructivist grounded theory. In one mid-sized Swedish hospital’s patient process organisation, data was collected from six QI teams that involved patients in their QI efforts, addressing care paths for patients with transient, chronic and/or multiple parallel diagnoses. Field notes were collected from participant observations during 53 QI team meetings in three of the six patient processes. Individual, semi-structured interviews were conducted with 12 patients and 12 healthcare professionals in all the six QI teams.ResultsPatients were involved in QI efforts in different ways. In three of the QI teams, patient representatives attended team meetings regularly. One team consulted patient representatives on a single occasion, one team collected patient preferences structurally from individual interviews with patients, and one team combined interviews and a workshop with patients. The patients’ and healthcare professionals’ expressions of what might influence the QI efforts involving patients were similar in several ways. QI team members emphasized the importance of organisational structure and culture. Furthermore, they expressed a desire for ongoing interaction between patients and healthcare professionals in healthcare QI.ConclusionsQI team members recognised continuous dialogue and collective thinking by the sharing of experiences and preferences between patients and healthcare professionals as essential for achieving better matches between healthcare resources and patient needs in their QI efforts. Significant structural and cultural aspects of performing QI in complex hospital organisations were considered to be obstructions to progress. Therefore, to sustain learning and behaviour change through QI efforts at the team level, a deeper understanding of how structural and cultural aspects of QI promote or prevent success appears essential.

Enhancing patient involvement in quality improvement: How complaint managers see their roles and limitations

Enhancing patient involvement in quality improvement: How complaint managers see their roles and limitations

How is patient involvement measured in patient centeredness scales for health professionals? A systematic review of their measurement properties and content

BackgroundPatient centeredness is an important component of patient care and healthcare quality. Several scales exist to measure patient centeredness, and previous literature provides a critical appraisal of their measurement properties. However, limited knowledge exists regarding the content of the various scales in terms of what type of patient centeredness they represent and how they can be used for quality improvement. The aim of this study was to explore the measurement properties of patient centeredness scales and their content with a special focus on patient involvement, and assess whether and how they can be used for quality improvement.MethodsA systematic review of patient centeredness scales was conducted in Medline, CINAHL, Embase, and SCOPUS in April and May 2017. Inclusion criteria were limited to articles written in English published from 2005 to 2017. Eligible studies were critically appraised in terms of internal consistency and reliability, as well as their content, structural, and cross-cultural validity. Type of studies included were scale-development articles and validation studies of relevant scales, with healthcare personnel as respondents. We used directed content analysis to categorize the scales and items according to Tritter’s conceptual framework for patient and public involvement.ResultsEleven scales reported in 22 articles were included. Most scales represented individual, indirect, and reactive patient involvement. Most scales included items that did not reflect patient centeredness directly, but rather organizational preconditions for patient centered practices. None of the scales included items explicitly reflecting the use of patient experiences of quality improvement.ConclusionsThere is a lack of patient centeredness scales focusing on direct and proactive involvement of patients in quality improvement. It would be useful to develop such instruments to further study the role of patient involvement in quality improvement in healthcare. Furthermore, they could be used as important tools in quality improvement interventions.

Exploring the phase for highest impact on radicality: a cross-sectional study of patient involvement in quality improvement in Swedish healthcare

ObjectivesInvolving patients in quality improvement is often suggested as a critical step for improving healthcare processes. However, this comes with challenges related to resources, tokenism, validity and competence. Therefore, to...

Patient involvement in quality improvement: is it time we let children, young people and families take the lead?

It is vital to involve children, young people and families in the design, delivery and improvement of their care. Their involvement can range from individuals giving feedback, such as patient...

Optimizing patient involvement in quality improvement

IntroductionPatient 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.MethodsThree case study quality improvement projects were purposively sampled from a broader programme. We used an ethnographic approach involving 126 in‐depth interviews, 12 weeks of non‐participant observations and documentary analysis. Data analysis was based on the constant comparative method.ResultsThe three projects differed in the ways they involved patients in their quality improvement work, including their rationales for including patients. We characterized three very different models of patient involvement, which were each influenced by project context. Patients played distinctive roles across the three projects, acting in some cases as intermediaries between the wider patient community and clinicians, and sometimes undertaking persuasive work to convince clinicians of the need for change. We identified specific strategies that can be used to help ensure that patient involvement works most effectively and that the enthusiasm of patients to make a difference is not dissipated.ConclusionPatient involvement in quality improvement work needs careful management to realize its full potential.