British Columbia Ministry of Health Patients as Partners: A transformational approach

Abstract

Patients as Partners is a quality improvement initiative of the British Columbia Ministry of Health (the Ministry) that aims to bring patient voice, choice, and representation to the forefront of healthcare through collaboration with patients, families, non-governmental organizations, funded partners, regional health authorities, and healthcare providers. A spectrum of patient engagement activities, including capacity building and self-management support, occur through partnerships at the individual patient and provider, community, and system levels. These activities ensure patient priorities are identified and embed a patient-centred care approach into provincial policies and projects. Multi-/interdisciplinary collaborations in the healthcare sector occur through participation in working groups, advisory committees, and engagement events. Ongoing improvements include enhancing measurement strategies and leveraging opportunities around gaps. The Ministry was honoured with the International Association of Public Participation Award as the 2016 Canadian Organization of the Year in recognition of improving healthcare through patient and public education.

Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review

“…The types of QI activities described in the papers were varied across service planning, design, delivery, measurement and evaluation (see online supplemental appendix B) for details. Many papers described specific QI initiatives such as streamlining patient bookings, 36 improving bedside rounding, 37 redesigning clinic physical layout, 38 improving understanding of advance care planning, 39 optimising timing of paediatric immunisations 40 and developing staff training regarding preventing harm. 41 Other papers were less specific and reported that patients worked on projects to improve general practitioner services for patients with back pain, 42 assisted teams to meet falls-related accreditation standards 43 or participated in audits regarding best practice for chronic disease.…”

Quality of patient, family, caregiver and public engagement in decision-making in healthcare systems: a scoping review protocol

“…Two researchers will independently collect and tabulate the characteristics of each article, including its publication year, authors, article type (eg, original research, policy and guidelines), country of origin, healthcare setting and any other characteristics agreed on by the research team. Two researchers will use directed content analysis,35 a qualitative data analysis technique, to independently extract relevant information from the articles by coding them within six major categories: ‘structure’, ‘process’ and ‘outcome’ from the Donabedian framework,11 and ‘individual (direct care)’, ‘community/organisation’ and ‘system’ domains from the British Columbia Ministry of Health’s engagement framework 8. Intercoder reliability between the two researchers for each of these six codes will be calculated as simple agreement using a subset of the articles at the start of the coding process 31 36.…”

“…In British Columbia, the Patients as Partners Initiative was created in 2008 by the Ministry of Health to build capacity for, and strengthen the engagement of, patients, families, unpaid caregivers and the public in decision-making in the healthcare system. With the goal as an enabler for advancing person- and family-centred healthcare in the province,6–8 this initiative supports activities to include a patient and family caregiver voice, choice and representation in decision-making. The Ministry of Health’s 2018 Patient, Family, Caregiver and Public Engagement Framework8 depicts decision-making as occurring in three domains of engagement in the healthcare system: (1) the individual domain which comprises a person’s and/or their family caregiver’s direct involvement in a person’s own care; (2) the community domain which denotes a person and their family caregiver taking part in activities related to healthcare programme and services and (3) the system domain which covers taking part in policy and strategic planning targeted at the healthcare system 8.…”

“…With the goal as an enabler for advancing person- and family-centred healthcare in the province,6–8 this initiative supports activities to include a patient and family caregiver voice, choice and representation in decision-making. The Ministry of Health’s 2018 Patient, Family, Caregiver and Public Engagement Framework8 depicts decision-making as occurring in three domains of engagement in the healthcare system: (1) the individual domain which comprises a person’s and/or their family caregiver’s direct involvement in a person’s own care; (2) the community domain which denotes a person and their family caregiver taking part in activities related to healthcare programme and services and (3) the system domain which covers taking part in policy and strategic planning targeted at the healthcare system 8. The ultimate goal of the Patients as Partners Initiative is to support achieving the quadruple aims of optimal patient and provider experience, better health outcomes and better cost-effectiveness 9 10.…”

“…Only limited evaluation tools within the community/organisation and system domains, such as the Public and Patient Engagement Evaluation Tool,18 are available with sparse evidence on their validity. Available frameworks define the levels and spectrum of patient and family caregiver engagement in healthcare decision-making 4 8. Other progress made in shaping the understanding of the quality of patient and family caregiver engagement in decision-making in healthcare systems include the Patient Health Engagement model5 and the Patient Health Engagement Scale5 which are both directed at the individual domain of engagement, and a systematic review of 11 evaluation tools focused on health system decision-making 19.…”