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Summary HPI4002 - Case 5: The patient as a partner
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Case 5 of the HPI4002 module
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Case 5: The patient as a partnerLearning goals
1. How to improve quality of care involving patients?
a. What is Shared Decision Making and why is it important for QI?
b. What is Personalized Healthcare and why is it important for QI?
c. How to measure patient satisfaction?
1. How can patients be involved in quality improvement?
The role of the patient in maintaining and improving the quality of care is much less well
defined than for instance the roll of staff members and general services. This lack of clarity
arises from three sources: political and managerial agendas converge this issue, there is wide
variety of policies governing patient involvement, and it remains difficult to link patient
perceptions and the outcomes to each other.
Patients also get more and more involved in quality management but also more and more in
research. Due to more use of the internet, patient can support each other and discuss their
illness. Moreover, they can compare the type and quality of their treatments which makes
them more involved. Also, the increase of public awareness results in more patient
involvement.
Three methods for involving patients in CQI
1. Micro-level patient involvement
At a micro level, patients can be directly involved in the decision making and
management plans associated with their individual treatment and in ensuring that
the intended treatment is given as planned and according to established protocols.
A patient should be engaged, active, vigilant, empowered. Another important term is
personalized care (= individualization of care and shared decision making).
2. Meso-level patient involvement (organization & community level)
At the meso level, patient involvement is about the appropriate, effective and safe
provision of services. As customer, patients involved at this level are engaged in
planning management and evaluation of the health system or individual services.
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, The mechanisms how they are involved vary. Examples are a part of a committee,
attending conferences or giving feedback anonymous via questionnaires.
3. Macro-level patient involvement (national & society level)
At this level, the patient is involved in safety activities at a national or international
level. For example, the WHO made the ‘Patients for Patient Safety movement’.
Also effective public reporting of quality of care involves patients and provides
information that is accessible and appropriate for patients.
Research showed that although patients have a positive attitude toward the idea of being
involved in their safety, their actual involvement varies.
We need to acknowledge that our science of measurement in patient involvement and
satisfaction needs to address that multi-layered complexity more directly and informatively.
The years of the ‘one-size-fits-all’ involvement and measuring this, is over.
Characteristics patient that makes involvement easier
- High health literacy
- High self-management
- Sense of self-efficacy
- Social economic issues; higher education level
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