Patient Advisory Groups in Practice Improvement

Abstract

Using patient advisory groups can affect practice changes and create a patient-centric focus for a primary care practice. A successful patient advisory group has been developed for our primary care clinics. Utilizing this group, we have implemented practice improvement changes that have had a significant impact in patient care. This will be demonstrated in a case presentation involving the implementation of depression care managers at our practice sites. We will review key "best practices," as defined by the group, regarding size, composition, and meeting frequency that can be used for the development of a clinical patient advisory group.

Promoting Patient and Family Partnerships in Ambulatory Care Improvement: A Narrative Review and Focus Group Findings

“…Activities included involvement in organizational decisions (e.g., service redesign and staff-interview panels) and point-of-care engagement (e.g., partners in care; inclusion in handoffs; 24/7 point of access)“Interviewees in five out of eight organizations cited the engagement of patients, families and carers as a critical strategy for promoting patient-centered care.” Acute inpatient facilities reported more extensive engagement Renedo et al [15]CLAHRC NWLCLAHRC NWL envisioned patient participation in QI becoming normal practice across local healthcare context; funded, trained, and supported individual teams of 8–10 multidisciplinary frontline staff from National Health Service organizations conducting QI initiatives. Patients involved in strategy development and ongoing improvement eventsPatients developed a sense of belonging and agency in interacting with healthcare professionals:”from being passive recipients of healthcare to becoming active participants in service improvement”Review articles Hubbard et al [41]Research and care planning efforts involving “people affected by cancer”Multiple activities including “one-off involvement exercises” and “user involvement partnerships” in policy and planningNo specific empirical findings reported Morrow et al 2013 [32]Mechanisms for partnership around chronic disease careAdvisory groups and patient-experience-based approaches to service design that link providers to community networks and support “perspective sharing” including patient input on agenda“Experiential knowledge” shapes relevant questions and improvement approachesCase studies Angstman et al [17]Mayo Clinic, US“Patient advisory group” (defined as involved in long-term patient-centered processes) in place 5+ years. Twelve members are Mayo patients or parents interested in improving clinic healthcare, volunteered or selected by medical director; others are medical director and administrator.…”

“…Examples of specific activities by patients on standing committees included strategy development [15], staff interviews [16], input on improvement projects [17] and workflow development [18]. In three studies [19–21], practice improvement efforts were part of regional healthcare planning efforts and patient/family partners helped identify local priorities.…”

“…Many articles reported that patient/family partnerships resulted in process improvements, including staff trainings [22, 26], service redesign [16, 17, 21, 27, 28], and patient materials (e.g., for self-management or new patient orientation) [18, 29–31]. Several articles said patient/family involvement catalyzed practice improvement through “influential stories,” “different perspectives” [26] or “experiential knowledge” [32].…”

“…In addition to improving organizational processes, several articles said patient partnerships benefited patients directly by encouraging deeper communication with providers and motivating improvement and management of personal health [14, 15, 31]. No study reported changes in clinical outcomes associated with engaging patient partners, although three [17, 33, 34] reported correlation with improvements in quality-of-care process measures, including health coaching and care coordination.…”

Integration of non-communicable chronic diseases (NCDs) and HIV/AIDS and mental health care through the involvement of chronically ill patients using empowerment evaluation

“…In Europe and the USA successful collaborations between staff and clients have been formed focusing on common areas of interest. 16,38,39 The difference in these papers was that most of them were funded and their innovations were not limited by money or other resources. It was made clear in the current research to all the groups that there would be no money in the project unless local donors could be accessed.…”