- Describe your topic.
- What is the issue or question? Question 1: What change management strategies are most effective at helping patients engage in behaviors to manage their chronic conditions and improve health outcomes? For which types of patients/conditions? Question 2: What is the evidence that having patient reported outcome information helps to engage patients in necessary changes in behavior to improve outcomes? Identify the population of interest, including details such as age range, gender, coexisting diagnoses, and reasons for therapy. Adults with chronic conditions (e.g., diabetes and hypertension) including vulnerable populations (e.g., indigent, minority, homeless, limited English proficiency) (Note: It would be most useful to stratify results by these subpopulations to understand variations in the effectiveness of the strategies/interventions.) Ambulatory care settings • Identify the interventions (treatments, tests, or strategies) that you want to know more about, and what are the appropriate comparisons. - Patient education methods - Mobile health technology (e.g., apps) - Peer support Note: As/if available, it would be helpful to provide evidence – and information on the strength of evidence – on how effective these interventions are for specific subpopulations, for example, those with chronic conditions and vulnerable populations (i.e., some interventions may work better in some subpopulations than in others, and it would be very useful to know that). Identify the important outcomes (health related benefits and harms) in which you are interested, such as improvements in symptoms or problems with diagnosis. - Safety and Quality: health outcomes, patient-reported outcomes such as fatigue or quality of life - Patient Experience: Patient engagement with PCP and healthcare setting including communication and trust - Costs/Value • For the health system • For the patient (i.e., the amount of time spent utilizing the intervention vs. expected effectiveness of the intervention)
- Describe why this topic is important.
- Patient and family engagement (PFE) plays a critical role in initiatives to improve the quality and safety of care in both inpatient and outpatient settings. Additionally, there is increasing evidence that meaningful PFE activities improve the patient experience (e.g., HCAHPS scores). However, there is often wide variation in how hospitals and other care settings adopt, implement, and sustain PFE. And, the science of measuring patient experience (e.g., HCAHPS and CAHPS) has not kept pace with policy and practice. For example, current survey tools do not ask about the family or caregiver experience and do not necessarily capture the range of patient experience across an episode of care and/or the continuum of care. With the increasing emphasis on the role of PFE as a quality improvement strategy – and emerging evidence from AHRQ and CMS about the benefits of PFE on quality and safety outcomes, health systems are seeking evidence on how to help their patients be more engaged in their health and health care. This interest is also driven by the increasing emphasis and mandates to report PROMs and financial incentives tied to patient outcomes (e.g., hospital readmissions) and potentially influenced by level of patient engagement and social determinants of health.
- Tell us why you are suggesting this topic.
- Evidence on the most effective interventions and strategies to engage patients in their health, health care, and health outcomes will help healthcare providers partner with patients and their family members to improve quality and safety outcomes as well as the patient experience. If appropriate contextual information is provided, it is possible that LHSs could learn to be more targeted in their interventions and help to reduce healthcare costs for all stakeholders in healthcare. In sum, this evidence would potentially help achieve better care, better health outcomes, and more affordable care, in accordance with the National Quality Strategy.
- Target Date.
- Describe what you are doing currently and what you are hoping will change because of a new evidence report.
- Currently, many health systems are trying to increase patient and family engagement with less than complete information about what is most likely to work. This is potentially quite wasteful in terms of time and dollars, and, also, in terms of well-meaning but ineffective interactions with patients. LHSs would find it helpful to have a synthesis focusing on the state of the science around measuring patient and family experience as well as identification of important evidence gaps.
- How will you or your group use the information from a new evidence report?
- An evidence report on more effective PFE practices will help LHSs understand how to incorporate them into their efforts to improve the quality of care as well as patient experience of care. It would also help to inform LHs how best to invest their resources.
- How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
- Many of the organizations represented on the LHS Panel are members of the High Value Healthcare Collaborative (HVHC) and could potentially distribute this report to other HVHC members. The HVHC is a provider learning network committed to improving healthcare value through data and collaboration. To accomplish this, the HVHC measures, innovates, tests, and continuously improves value-based care. Rapidly disseminate and facilitate adoption of proven high value care models across HVHC members and beyond. Within the LHSs represented on the panel, findings from the evidence reports would be disseminated internally to leadership as well as operational and clinical staff to support implementation of interventions to increase patient and family engagement within the context of their organization and patient population. Additionally, several of the LHS panel members are members of the Health Care Systems Research Network (HCSRN), an innovative consortium of research centers based on community-based health delivery systems. Thus, the LHS panel members could potentially disseminate this report to other HCSRN members.
- Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
- Information About You: (optional)
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- Provide a description of your role or perspective.
- Chief Research Officer
- If you are you making a suggestion on behalf of an organization, please state the name of the organization.
- <names>, AIR, <email address>, <phone number>
- Please tell us how you heard about the Effective Health Care Program.
