Barriers to patient involvement in health service planning and evaluation: An exploratory study

Gagliardi, Anna R.; Lemieux‐Charles, Louise; Brown, Adalsteinn D.; Sullivan, Terrence; Goel, Vivek

doi:10.1016/j.pec.2007.09.009

Cited by 100 publications

(137 citation statements)

References 58 publications

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“…In total 68 papers were eligible for inclusion; these described the result of initiatives involving patients" in safety or studies of patients" perspectives of being actively involved in the safety of their care. Gagliardi et al, 2008). However, Watt et al (2009) found that older study participants refuted a suggestion by others that older people would find asking questions more difficult.…”

Section: Resultsmentioning

confidence: 98%

Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review

Doherty

Stavropoulou

2012

Social Science & Medicine

148

149

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This systematic review identifies the factors that both support and deter patients from being willing and able to participate actively in reducing clinical errors. Specifically, we add to our understanding of the safety culture in healthcare by engaging with the call for more focus on the relational and subjective factors which enable patients' participation (Iedema, Jorm & Lum, 2009; Ovretveit, 2009). A systematic search of six databases, ten journals and seven healthcare organisations' web sites resulted in the identification of 2714 studies of which 68 were included in the review. These studies investigated initiatives involving patients in safety or studies of patients' perspectives of being actively involved in the safety of their care. The factors explored varied considerably depending on the scope, setting and context of the study. Using thematic analysis we synthesized the data to build an explanation of why, when and how patients are likely to engage actively in helping to reduce clinical errors. The findings show that the main factors for engaging patients in their own safety can be summarised in four categories: illness; individual cognitive characteristics; the clinician-patient relationship; and organisational factors. We conclude that illness and patients' perceptions of their role and status as subordinate to that of clinicians are the most important barriers to their involvement in error reduction. In sum, patients' fear of being labelled 'difficult' and a consequent desire for clinicians' approbation may cause them to assume a passive role as a means of actively protecting their personal safety. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63

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Section: Resultsmentioning

confidence: 98%

Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review

Doherty

Stavropoulou

2012

Social Science & Medicine

148

149

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“…Involving patients in healthcare evaluation has patient support, preferably via ongoing initiatives rather than passive methods such as surveys (Gagliardi et al, 2008;Kielmann et al, 2011). However, the preconception among patients and staff is that patients are relatively passive when it comes to involvement initiatives (Forbat et al, 2009).…”

Section: Patient Involvement In Service Innovation From a Patient's Pmentioning

confidence: 99%

Patient involvement and service innovation in healthcare

Engström¹

2014

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This thesis adds to a stream of research suggesting that healthcare can be more patient centered and efficient by redefining the role of the patient from a passive receiver to a more active and collaborative participant. This may relate to healthcare provision (Anderson and Funnell, 2005;Berry and Bendapudi, 2007;Bitner and Brown, 2008;McColl-Kennedy et al., 2012;Nordgren, 2008) and innovation (Bate and Robert, 2006;Groene et al., 2009;Longtin et al., 2010). Through research initiative containing four healthcare units and 68 patients, the present thesis combines healthcare research (e.g., Anderson and Funnell, 2005;Nelson et al., 2002) with service research (e.g., Grönroos, 2006; Lusch, 2008, 2004) to explore three aspects of patient involvement and service innovation.Firstly, the concept of patient involvement itself is investigated through an extensive literature review of empirical research on patient involvement. A model describing the antecedents, forms and consequences of patient involvement is proposed. What value is, and how patients can co-create value is discussed from the perspectives of healthcare research and service management thought.Secondly, the thesis proposes a diary-based methodology for involving patients in service innovation. My colleagues and I developed the methodology in collaboration with the participating care providers and applied it in practice. We used the experiences we gained from the project and the contributions from the patients to examine the opportunities for user involvement in service innovation. The participants contributed with ideas and insights stemming from their experiences in their contact with healthcare and other resources. We suggest the following three ways of learning from the collected data: As ideas for improvements; through summary reports to illustrate other quantitative data; and as narratives to promote change. Thirdly, the thesis explores patients' motivations to participate in service innovation, a hitherto unexplored field. Through an analysis of patients' contributions and interviews with participants we found that there are a number of factors that motivate patients to participate and that participation is perceived as a social-and meaning-laden event. Patients derive psychological well-being and support from participation, but disease was sometimes a barrier to participation. This thesis elaborates on how the most motivated users can be involved in service innovation, applying thinking from the lead-user methodology to a healthcare setting.Overall, the thesis explores patient involvement from new perspectives and, by doing so, adds to our collective efforts to improve healthcare. viii Key words: Patient Involvement, participation, co-creation, patient empowerment, user involvement, patient centered care, motivation, user experiences, co-creation, service development, service innovation, service design, health care, lead users, diary, value ix SAMMANFATTNING Denna avhandling syftar till en mer patientcentrerad och effektiv sjukvård. Den bid...

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“…While there are numerous empirical studies of health care customer practices and methods for involving and managing health care customers (e.g., Elg et al 2012;Gagliardi et al 2008;Street and Gordon 2006), there is a lack of studies synthesizing these findings. In addition, creativity among health care customers, with a few exceptions, has not previously been conceptualized.…”

Section: Purpose and Research Questionsmentioning

confidence: 99%

“…Several studies have identified knowledge as an important factor influencing the level of participation in decision making (Makoul and Clayman 2006;Joseph-Williams, Elwyn, and Edwards 2014). Outside the health care setting, knowledge and experience has been identified as important to manage illnesses and be confidant in performing self-care (Barlow et al 2002;Gagliardi et al 2008). Experience and knowledge imply greater contextual awareness of the health care customer, enabling them to be better able to detect health-related problems (Hill-Briggs 2003).…”

Section: Knowledge and Experiencementioning

confidence: 99%

Health Care Customer Creativity

Snyder¹

2016

Linköping Studies in Science and Technology. Dissertations

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Crafting and stimulating service innovation is considered a main research priority and remains a challenge for service providers. One suggested component of stimulating service innovation is customer creativity. Customers who adapt, modify and transform services or products to better suit themselves are increasingly being recognized as a source of competitive value and innovation. It has been proposed that understanding and supporting the customer's value creating practices is the key to creating and sustaining value over time in health care. Health services directly address a customer's well-being and have a significant impact on his or her quality of life. In these types of services, the service outcome is highly dependent on the activities of the individual customer. Health care services often require customers to participate extensively, over long periods of time, with limited support and control. Health services also stretch far beyond the particular service setting into the customer's daily life. While research, policy, and legislation have all emphasized the active role of health care customers, such customers have traditionally had few opportunities to design their health care services. Nevertheless, health care customers solve health-related problems and engage in self-care and medical decision-making on a day-to-day basis, although this creativity is often unknown to the service provider.To understand how health care customers can enable service innovation, this thesis seeks to conceptualize and investigate the concept of customer creativity in health care. The thesis focuses on customer creativity, not only as an outcome, but also as a dynamic and contextualized process that can be enhanced. The thesis combines insights from health care research with service and innovation research to provide build a framework for health care customer creativity. Building on five papers, the research develops an understanding for health care customer creativity. The individual papers are based on systematic literature reviews as well as empirical data in the form of customers' ideas for service innovation collected through diaries.The results of the thesis suggest that despite the negative nature of the service, health care customers are creative. Given the opportunity, health care customers can provide creative ideas and solutions on a multitude of aspects, both within and outside the health care setting. This provides the potential to view the health care experience through the customers' eyes and take part in their creativity in spheres where the service providers have not traditionally had any access. This thesis contributes to the literature by providing a framework for health care customer creativity that recognizes the concept as a complex interplay of factors operating at the individual, contextual, and situational levels. The proposed framework specifies the health care specific factors upon which customer creativity depends, with the intention of positing potential research directions and developing ...

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Barriers to patient involvement in health service planning and evaluation: An exploratory study

Cited by 100 publications

References 58 publications

Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review

Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review

Patient involvement and service innovation in healthcare

Health Care Customer Creativity

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