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Marisa Granieri, Jennifer Schipper and Amy Lang

Showing how patient partnering is improving care

Over the last decade, patient partnering has grown in Ontario to the point where it is a significant part of the culture and practice of improving health care quality. It supports a high-quality health system by bringing a vital source of insight to the table and ensuring that the work being done is relevant to patient needs. If it’s done well, patient partnering produces better patient experiences, better health outcomes and increases public trust in the system.

Plus, patients want to be included as partners. They know they can make a difference in driving positive changes and to improving health outcomes.

But how does one pinpoint the desired effect of patient partnering? We all feel patient partnership is the right thing to do, but how do we know if it is being done in a way that is truly meaningful for both patients and health care professionals?

One way to evaluate the impact of patient partnering is to understand what insights are being collected and how they are being applied to the work of improving care, case by case and cumulatively over time. Evaluation helps us know whether changes made to improve care are grounded in patient needs.

Evaluating the impact of patient partnering can be a challenging task. As a recent study put it, “drawing causal associations between engaging patients in health services improvement and health outcomes is difficult.” But there are indeed ways to evaluate short and medium-term patient partnering impacts that organizations can begin to measure today and based on their specific objectives. It’s a challenge that Health Quality Ontario (HQO) and its patient partners have started to tackle in consultation with researchers at McMaster University, and is based on HQO’s current organizational objectives.

Take for example Health Quality Ontario’s work with its Patient, Family and Public Advisors Council and broader Patient Advisors Network (of 600+ people from across the province). The short- and medium-term patient partnering goals that Health Quality Ontario now measures for these programs include:

  • Whether patients feel their experiences and insights influenced the health care quality topics HQO chooses to study, the content of its reports and its recommendations, and its programs to improve care,
  •  And whether Health Quality Ontario staff feel they are gaining insights from patients and what they are doing with these insights.

This information is being gathered and reflected upon to evaluate HQO’s collaborative relationship with patients as partners, and where they are making a direct contribution to its work. In the coming months, we hope to share what we are learning with others across the health system, to help enable their own patient partnering evaluation efforts.

Health Quality Ontario is also taking baby steps to measure the influence of patient partnering on care delivery. Through an annual patient partner survey, Health Quality Ontario will probe if partnering with Health Quality Ontario has increased patients’ knowledge about health care quality issues along with also impacting their ability to participate in improving health care delivery at the local level (within their own health care organizations) and what changes they have seen. And as we collect feedback from system stakeholders about our programs, recommendations and reports, we will ask if patient involvement has increased their confidence to use our work.

An annual patient partner survey is a start to try and quantify the change in patient partners’ knowledge of health system quality issues, their ability to participate to drive change, and the changes that they have observed.

As another recent study put it, “Ultimately, the effectiveness of any patient engagement should be judged by its impact on patient care.” Plus, health care organizations need to be sure they are leveraging patient insights and experiences effectively as they work to improve care. And, patient partners are ready to measure their impact. Not to validate why they are at the table, but to concretely measure the effect they are having on health outcomes.

Evaluating the impact of patient partnering takes us a step closer to meeting all of these those goals.

Marisa Granieri is a patient partner at Health Quality Ontario, Jennifer Schipper is Chief, Communications and Patient Partnering, Health Quality Ontario and Amy Lang is Director, Patient and Public Partnering, Health Quality Ontario.


8 comments on article "Showing how patient partnering is improving care"

David Smith

Great article.

Can you suggest any key references that look at the equally important issue of frontline staff engagement and how individual health care professionals can successfully partner with other members of the interdisciplinary team.


Dave Smith


References are available from similar studies on a few sites I follow.

I am working on a start-up service in non-profit employment dedicated to employment for adults in recovery with Schizophrenia.

Any thoughts?

Mira Steranka

That is exactly my question. I read the study and it looks great but it is only on the paper. How does it translate to actual care provided by the front line staff and most of all individual health care professionals. From my own past experience no one ever listen to my input. When I complained and if I received any answer it was always a vague explanation, no apology and most importantly no corrective action was ever taken.


I couldn't agree more. There appears to be a lack of reliable research evidence around what criteria to measure re. success. Short-term and long-term.

I am working on a start-up service in non-profit employment dedicated to employment for adults in recovery with Schizophrenia.

Any thoughts?

Bob Hogan

How can we help hospitals and their physicians, to support their patients who transition to outpatient or clinic relationships with their team ?

How do we measure the hard and softer human cost of perceived Health Care System abandonment patients feel once when they leave Hospital. Is there an existing metric related to patient relationships with community support following discharge from a Hospital.

Gwen Piller

I am involved with hospital and Lhin patients and family advisory committee which does deal with front line managers, programs, and planning. Community services also have advisory committees, approach these programs, hospitals, and now Ontario Health Teams which are now forming to be more involved with frontline staff. My experience is they are out there at least in urban areas.

Marie-Pascale Pomey


You can look at the special issue of Healthcare quarterly

Special Issue on Canadian Patient Engagement Revolution. vol 21:38-45. Healthcare Quarterly. you will find a lot of interesting articles.

one article is especially on how to prepare the team to be in partnership with patients

Pomey, MP, Lebel, P, Clavel, N, Morin, E, Morin, M, Neault, C, Tetrault, B, Ewalds, A-P (2018) Development of patient-inclusive teams: Towards a structured methodology, Special Issue on Canadian Patient Engagement Revolution. vol 21:38-45. Healthcare Quarterly

Chado Brcic

Good article. Quantifying/measuring I feel is quite difficult.

As a patient partner with UHN, I am aware of projects I was involved in, actually going to/or being implemented, such as a number of CAP initiatives, among many I have reviewed. I believe the Patient partnering does work. I have learned a great deal and passed on great health system knowledge to friends and colleagues from my involvement.

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