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Patient Engagement Why is it so important and what can we
do to achieve it?
Patricia F. Donehower, MSN, RNVice President of Clinical ServicesVisiting Nurse Association of Chittenden and Grand Isle CountiesVermont, United States
May 7, 2014
Patient Engagement
Engagement is the Goal
Patient engagement is the ultimate goal
An “engaged” patient works toward outcomes she/he
cares about
Individualized care results in engaged patients
It’s not a “one size fits all”
Its not a one step process
5
Getting Better at Patient Engagement
Caregivers must uncover what is important to the patient
and what the patient’s strengths are
Achieving patient engagement takes skill and practice
And leadership and encouragement
6
Nurse Monitors – This is Good
Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties
7
Patient Monitors – This is Better
Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties
8
Steps Toward Engagement
Health literacy
Communication with patient and family
Motivational interviewing
9
Health Literacy
Materials appropriate to patient and patient
educational level
Everyone learns at his/her own rate
10
Communication with Patient and Family
Use teach back technique
Present information three times, three different ways
Caregivers use consistent materials
Involve family and support persons
13
What is Important to the Patient?
Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties
14
Mobility
Independence
Fresh air
Motivational Interviewing
Assess patient readiness
Develop patient centered goals
Strive for patient self management
15
PDSA for Patient Engagement
Plan
– Mr. Clausen will monitor blood glucose daily for next three days
Do
– Patients agrees and states he understands why he should test
his blood sugar
17
PDSA (continued)
Study
– Nurse reviews blood glucose record and asks client how
he is doing
– Client states he tested two day/skipped one day because
he was sick and didn’t eat
Act
– Opportunity for teaching
– Ask Mr. Clausen to describe how he will handle days when
he feels sick
– Revise plan and set new goals for next three days
18
Training for Patient Engagement
Teach skills and techniques of motivational interviewing
Develop a documentation system to support patient
centered goals
19
Barriers to Patient Engagement
Photo credit: www.6minutes.com.au
20
Isolation
Depression
Forgetfulness
How do we Measure Engagement?
Measure competency of staff
Measure number of patients who increase in readiness
Measure number of patients with self management goals
Measure patient and family perception of the plan
21
Reaching Patient Engagement
Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties
22
In Summary23
Patient engagement is the engine behind change
and improvement
Patient engagement requires time and small,
steady steps
Practice and encouragement builds engagement
– Managers understand staff needs and encourage their efforts
– Staff understand their patients’ needs and encourage their efforts