Question

Design an Engagement Plan for your patients and their families that will result in improved clinical outcomes, greater engagement (i.e. shared decision making) and financial performance. The paper should include the following at a minimum:

assessment of the need or opportunity, i.e. what is the need being addressed? Why is the need there?

readiness for change, i.e. why the need for change? Why this, now?

identification of goals and resource needs, i.e. roles, functions, systems, dollars needed

selection of performance tracking methods, i.e. how will you judge the success or failure of the action plan and

revenue improvement or cost containment i.e. how will this improve your financial position and/or reduce your costs

Answer 1

Need being addressed - process of building the capacity of patients, families, carers, as well as health care providers, to facilitate and support the active involvement of patients in their own care, in order to enhance safety, quality and people-centredness of health care service delivery, which will help and improve clinical outcomes

Why the need for change? Why this, now? -  Engaged patients are better able to make informed decisions about their care options. In addition, resources may be better used if they are aligned with patients’ priorities and this is critical for the sustainability of health systems worldwide. People using health services are increasingly asking for more responsive, open and transparent health care systems. They expect practitioners to engage them in the decision-making process, although individual patients may vary substantially in their preferences for such involvement.

Goals and resource needs, i.e. roles, functions

1. Educating health care providers about patient engagement n educating health care providers to involve patients, both at the organizational and individual level; n including patient engagement and safety in educational curricula at undergraduate and postgraduate level; n developing a learning culture, rather than a blaming culture.

2. Supporting patients to become actively involved n encouraging patients to report on safety incidents, near misses and safety concerns; n actively promoting patient feedback systems; n giving feedback to patients on follow-up actions taken about the issues they raised; n considering legislation that supports patients and their families to engage in issues relevant for their safety; n providing patients with appropriate, accurate and up-to-date information about treatment and safety issues in a user-friendly language and format.

3. Address patient engagement regulations. Four federal programs (value-based purchasing, meaningful use of electronic records, avoidable hospital readmissions and the creation of accountable care organizations) will significantly impact hospitals through the use of Medicare penalties and incentives. In order to qualify for the incentives and avoid penalties, hospitals will have to go beyond simple "check-box" processes and employ new patient engagement strategies that actually work to improve outcomes and the overall patient experience.

4. Leverage existing investments. A number of solutions are available to help hospitals meet their patient engagement goals, but many are cost-prohibitive. Hospitals should consider deploying a solution that allows them to leverage their existing investments (i.e., technology infrastructure and high-definition televisions) to deliver interactive tools, information and education to patients.

5. Define the patient's role. In order to effectively engage patients and their families, hospitals need to clearly communicate what their roles are, provide them with tools that facilitate collaboration and explain the benefits of participating in the care process.

6. Assess individual patient needs. As part of the admission process, hospitals should incorporate a brief needs assessment that captures baseline information critical to patient engagement. This survey tool can help determine a patient's health literacy, identify the need for assistive devices and alert the care team of any additional factors that may impact comprehension and, subsequently, clinical outcomes.

7. Tailor information to the individual. Hospitals should use information gleaned from a needs assessment to deliver information about a patient’s condition or hospital stay in a format they understand. The more relevant the information is to a patient's circumstances, the greater the probability that the information will be reviewed, remembered and acted upon.

8. Educate the patient. The more patients know about their conditions, what treatment is needed (and why) and the consequences of not following instructions, the more likely it is that they will actively participate in their care, adhere to treatment plans and make healthy lifestyle decisions.

9. Grant control to patient. The care experience must be tailored to meet the individual needs of each patient. Some prefer to operate independently, with minimal non-essential interactions, while others expect frequent interactions with hospital staff. A patient engagement system can provide information and tools patients need to help manage their own experience. This flexibility and guidance helps reduce anxiety, makes them more comfortable interacting with their providers and encourages dialogue about health-related issues.

10. Deliver information at the right time. Research has shown that even under the best circumstances, patients forget half of what a physician tells them almost immediately. An effective patient engagement system provides easy-to-understand, conveniently accessed, relevant video content at appropriate times throughout a hospital stay. Following discharge, hospitals can maintain patient communication by delivering additional videos and information to a patient's smartphone, computer or Web-enabled TV.

11. Track patient comprehension. Quality, safety and financial improvements will result if patients understand the information and instructions they are given. Hospitals can easily ascertain whether individuals comprehend the educational content they watched through automatically triggered targeted questions. The tool can alert care team members if responses suggest a patient needs additional intervention prior to discharge.

12. Support care transitions. It is critical that hospitals educate patients about their inpatient treatment, but they also need to start preparing patients for discharge as soon as they are admitted. This gives patients — as well as their family caregivers — an opportunity to absorb information and ask questions while they are still hospitalized. A patient engagement system can not only assess an individual's readiness for discharge, but it can also capture patient-provided information during the hospital stay and document in the EMR, where it can be accessed by additional providers and the patients themselves throughout the care continuum.

Dollars needed - around 2-3 percent, depending on the curriculum

how will you judge the success or failure of the action plan ?

Obtaining feedback

Engaging for improvement