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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.

Pain and parking: Capturing the patient experience

Zal Press and Anna Greenberg

A patient’s experience interacting with the health care system is one of the most important indications of how well that system is functioning. In fact, better patient experience is one of the four parts of the Quadruple Aim for health care systems (along with better outcomes, lower costs, and an improved clinician experience). Here, patient advisor Zal Press (@PatientCommando) and Health Quality Ontario’s Interim President and CEO Anna Greenberg provide their perspectives on measuring the patient experience.

Zal Press: How do patients measure their experience in the complex world of health care? Since their reason for using the system can be about pain, let’s start there. Patients are often asked to measure their pain on a scale of 1 – 10. However, as a Crohn’s patient, the pain in my gut often feels like there’s a cat trying to claw its way out and there are many times when my pain meter hits a 12 and even a 15. Pain is also a measure of success. I remember forcing myself to get up to walk, just a day after my bowel resection, to nurture the ultimate measure of a successful bowel surgery – the passing of gas.

Anna Greenberg: For years there has been a disconnect between the type of real-world experiences of patients like Zal and how the system measures their experiences. Standardized surveys are the go-to tool used by hospitals and others to measure patient experience. However, many surveys reflect the provider or administrator view of what’s important, not the patient’s perception of what’s important, and getting access to survey results (let alone using them for improvement) can take too long. Further, organizations often focus on what happens within their four walls rather than the entire experience a patient may have, such as what it was like to be discharged from hospital.

Patient partnering: A blossoming movement


A Conversation with patient advisor Diane McKenzie and Chief of Communications and Patient Partnering, Jennifer Schipper

Diane McKenzie: Patient partnering means building deeper, long-term relationships with health care professionals that lead to improved health care quality. This work is about challenges that need to be overcome. By working through those challenges – together – patients and organizations can make dramatic changes. It’s not easy. But together we are better when we are done.

Jennifer Schipper: When I first started at Health Quality Ontario more than four years ago, I was keen to “engage” patients and find out how we could work together.

One of my first meetings was with the founding president of Patient’s Canada, Sholom Glouberman, who told me: “Jennifer, patients don’t want to be engaged when it comes to health care improvement, they want to be married.”

Sholom’s phrase and sentiment has stayed with me ever since and has helped guide how Health Quality Ontario is working to help patients, health care professionals and organizations truly partner to effectively improve the quality of health care.

The speed at which this is occurring and the associated changes in language about this trend can be overwhelming to those who are not directly involved. For example, the concept of ‘patient engagement’ which was so dominant so recently, has largely been replaced by the more proactive concept of partnership.

Making Patient Engagement Meaningful and Measurable

(Join Health Quality Ontario CEO Dr. Joshua Tepper and patient advisors Emily Nicholas and Claude Lurette for a tweet chat to discuss this topic on Wednesday, September 27 at 7:00 p.m. (ET)).

Involving patients in the planning, delivery and assessment of health care is core to supporting high quality care. Involving patients helps us achieve patient-centredness which is one of the defining dimensions of a quality health system.

Last year, Health Quality Ontario released the province’s first Patient Engagement Framework to define a common approach for engagement across the province and guide people in planning for implementing and evaluating patient engagement activities across the health system from personal care to system-wide governance. Engaging patients at all levels is a relatively new process so such a framework is not intended to be set in stone and could evolve as more work is undertaken to understand the whole process.

But how does one make that engagement meaningful and how do you assess the impact of that engagement? How do we know engaging patients is making a difference?

Important Health Quality Insights from the Twittersphere

Dr. Joshua Tepper

That the patient perspective was mentioned first in our Twitter chat about quality in health earlier this week was both gratifying and appropriate.

Ditto the fact that a number of individual members of the public and patient advocates participated in the one hour #HQOchat, which represented the first time Health Quality Ontario has hosted a discussion on Twitter.

Let’s make our health system healthier

Join Our Patient, Family and Public Advisors Program

Patients, families and the public are central to improving health quality.


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