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Patients and Patient Experiencethe right structure and the right tool
Adam Thompson
NQC Peer Consultant
February 5, 2013
Welcome and Introductions
3
History of Involvement
• Fingerprints – The Denver Principles; Authors and Souls
• Blueprints – The Ryan White Program; Drafters and
Supporters
• Nuts and Bolts – Community Planning Members
• Betterment – Quality Improvement Advocates
4
Patient Activation
“A fundamental belief underlying efforts to
reshape health care institutions and systems is
that patients who are activated to participate in
their own health care are more likely to adopt
healthy behaviors leading to improved health
outcomes.”
(van Korff et al. 1997; Bodenheimer et al. 2002a, b’ Mosen et al. 2007)
5
Four Stages of Patient Activation
• Patients:
Play important roles in self-management
Possess knowledge needed to manage their
health
Act by using their skills and behaviors to
maintain well-being
Manage stress and stay the course
6
Champions and Experts
• Champion
(noun) - a person who vigorously supports or defends a
person or cause
• Expert
(noun) - a person who is very knowledgeable about or
skillful in a particular area
(adjective) - having or involving a great deal of knowledge
or skill in a particular area
7
Identifying a Champion
• Draw from your ENTIRE patient population
• Choose patients who
Are self-managing patients
Demonstrate prosocial characteristics
Are comfortable with and have access to technology
Are able to commit to a defined period of involvement
Can work collaboratively
Express a desire to learn new skills
• The “squeaky wheel” might not be the best choice
8
Dimensions of Quality
Technical Quality
Provider Perception
of Quality of HIV
Care
Experience Quality
Patient Perception of
Quality of HIV
Care
Leonard Berry, Texas A&M University, IHI conference 2001
9
Preparing a Champion
• Recognition of patient experience as only a foundation
• Identification of Capacities for Quality Management
Performance Measurement
Computational Skills
• Statistical Calculations
• Evaluating Data
Quality Improvement & Management Models
• Advocacy Skills
10
Developing an Expert
• Adult Learning Theory
• Facilitation of Disenfranchised Learners
Math
Science
• Building Capacity of Non-Medical Professionals
Performance Measurement
Data Analysis
Quality Management
11
Patient Involvement in Quality Management
The goal is to incorporate
Patients and Patient Experiences
into quality improvement activities.
Patients and Patient Experience
13
Question
How are you currently utilizing
patients and/or patient experience
in your systems or service delivery
improvement activities?
14
What am I trying to do?
15
Patient Involvement Structures
Consumer Advisory Boards
Statewide Planning Bodies
Regional Planning Bodies
Clinical Quality Teams
Organizational Boards
• Statewide
Planning Groups
Advisory Groups
• Regional
Consortia
Planning Councils
• Local
CABs
Quality Teams
Organizational Boards
16
Qualifications, Expectations, and Selection
Consumer Advisory Board
• Qualifications
Meeting Participation
Person Living with HIV
• Expectations
Provide Input and Feedback
Share Personal Experience
• Make-up
Demographic Based
Quality Management Team
• Qualifications
Meeting Participation
Person Living with HIV
Knowledge and Skills of QM
• Expectations
Provide Input and Feedback
Support QI Activities
Team Responsibilities
• Make-Up
Skills Based
17
Tools for Collecting Patient Experience
Assessments
Focus Groups
SurveysTown Halls
One on One
• Solicitation Methods
Needs Assessments
Focus Groups
Surveys
Key Informant Interviews
Community Town Halls
Patient-Provider
Conversations
18
Patient Experience
19
Utilizing Structures and Tools Effectively
20
Planning for Effective Patient Involvement
• Structures
What skills, traits, or qualities will the patient need to be
involved within this structure?
What structure will help us achieve our goal(s)?
• Tools
What kind(s) of information am I seeking?
What tool(s) will give me the best information?
Training of Consumers on Quality
(TCQ) Activity: Decision-Making
22
You Decide!
• Using the Decision-Making Model Handout, make an
estimate of how many candies you think there are in the jar.
• You will make an estimate of the number of candies a total
of four times.
• Each round you will make an estimate with more of your
peers as part of the process.
• You must each round only make a single estimate per group!
23
Consensus Decision Making
• Process towards decision is collaborative
• Environments of trust, team-attitudes, and relationships can
best adapt this style
• Actively seeks the opinions of all persons in the decision-
making process
• Engaging process that relies on series of votes in order to
establish a majority and/or stand-aside minority votes
• Process can be easily undermined by malevolent use of block
votes
24
Key Points
• Incorporating Patients and Patient Experience requires
planning and understanding.
• There are many structures and tools that can help us improve
our services.
• Different structures require different skills and people to
work effectively.
• Using more than one tool helps us to get a better picture of
our services and systems.
• Using the structures and tools in the right way can help us to
better our improvement processes.