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Creating a culture of patient engagement
A clear vision provides basis for implementing tactics
In 2008, a workgroup at ProHealth Care in Waukesha, WI, will begin the process of selecting approaches to meet the goals of 16 tactics developed to create a culture of patient engagement.
For about a year, the workgroup, consisting of representatives from all divisions of the medical facility, met regularly to draft "The Partnership with Patients Work Plan."
The partnership, with patients' effort, evolved from the annual strategic planning process, says Janet Schulz, MBA, chief integration officer for ProHealth Care. There were a lot of tools in place to benefit the patient in terms of his or her health care, such as on-line immunization and appointment reminders. But she was concerned that the tools were not cohesive.
"My concern at that point in time is that we hadn't found a way to knit all those tools together in a way that really made the patients feel that ProHealth was their partner in their health care," explains Schulz.
The workgroup was formed to coordinate and develop tools for a true partnership experience for patients. Before the team could begin to shape the plan, they needed to determine what a patient partnership should look like. A literature search was in order. They also looked at information from the Institute of Family-Centered Care in Bethesda nd a book of case studies published by The Joint Commission, titled "Patients as Partners."
From the information, the group wrote a vision statement. It reads: "Through partnership, PHC will build and maintain trust with patients and families, respect and honor choices, and create a healing presence from the first moment of contact."
The major themes within the vision statement were used to form 16 tactics. "Once we had our vision statement we said, 'How does this really play out operationally,' and that is where we developed our tactics," explains Schulz.
"Communication and patient education are incredible drivers in building and maintaining trust, respecting and honoring choices, and creating a healing presence," she adds.
The group created a tactic for consistent patient and family communication and goal setting. They researched several strategies for support. For example, they are considering implementing the "Ask Me 3" program or doing multidisciplinary rounds. Patients were asked what type of communication they would like to have with staff during their hospital stay as well.
Clinics are also considering how to rewrite their pre-visit questionnaire to determine what might be important to patients in a partnership relationship with their physician.
Under the "respect and honor choices" of the vision statement, methods to help staff better understand patient choices, such as dietary preferences or wishes in regards to family involvement, will be implemented.
Creating the culture
A cultural training program called RAYS (Reinvigorating and Affirming Your Spirit) will be implemented this year. The program helps staff members learn how to support one another so they can better support patients and families.
The program bolsters the "healing presence" portion of the vision statement, says Schulz. It isn't always possible to fix what is wrong with the patient so health care practitioners must learn that the best role for them, from a partnership perspective and a healing presence, is to just be there for the patient and listen to him or her in such a situation.
As the concept for a patient partnership develops, staff members are being told the health care system is building on what is already established.
Woven into the work plan are methods for staff education as well as leadership education and orientation. This year the leadership orientations will begin in order to explain the work plan and the vision. Some education will take place through routine communication channels but when there is a significant education piece, training will be built around it. For example, if bedside rounds are implemented staff will receive training on this process.
In a patient partnership, staff start where the patient is in the journey and walks with him or her, all the while communicating in a way that is understandable. In a patient partnership, staff don't try to pull the patient to their level, and if patients decide to stop walking it's their choice, Schulz says.
For more information about the workgroup, contact: