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A Mad Hatter’s Tea Party: Inviting Patients to the Table

A Mad Hatter’s Tea Party: Inviting Patients to the Table . Literature Review. Partnering with Patients. It’s personal Experience first hand Changes the conversation Valuable resource Shared accountability. Patient-Centered Safety. Discordance. Focus Groups. Policy & Governance

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A Mad Hatter’s Tea Party: Inviting Patients to the Table

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  1. A Mad Hatter’s Tea Party: Inviting Patients to the Table

  2. Literature Review

  3. Partnering with Patients • It’s personal • Experience first hand • Changes the conversation • Valuable resource • Shared accountability

  4. Patient-Centered Safety

  5. Discordance

  6. Focus Groups

  7. Policy & Governance • Education • Tools • Management & Executive Support • Recommendations • Ask Patients • Ask Leaders

  8. Clinical Leaders • Ask the Patient • Need to understand the right questions to ask • Dynamics of engaging public • Variety of ways patients can serve • Quality improvement teams • Safety and quality committees • Grievance committees • Co-evaluator of service • Executive position

  9. The Patient, The Family • Guard • Education • Patient education • Community role • Health care provider education • Committee and policy work • Advisory roles • Selection role • Planning committees

  10. Themes • Education • Means to improve engagement • Means of engagement • Group Work • Committees • Policy development • Advisory councils Culture

  11. Conclusions • Patient voice must be heard • Patient safety issues exist outside the hospitals • Culture seen as barrier • Education seen as key

  12. Recommendations Ask Patients, Ask Families The Stories Narratives in patient safety week Patients stories for presentations Case studies as learning tools Patient reporting of events Community outreach education Public forums, focus groups, means of providing input

  13. Recommendations Small change focus – ripple effect, incremental change that sticks Offer concrete suggestions on steps to start Present tools to assist in change Training patients for involvement Patient selection and insertion into existing committees Appropriate measures that can be tracked and collected easily

  14. Use the media Recommendations

  15. Research needed Non-health care provider patients Primary care safety issues Never harmed patients Does monitoring role increase safety? Creation of harm through participation Recommendations

  16. Recommendations Roles must fit within present culture Is Handwashing monitoring – setting patients up for failure and guilt?

  17. Thank You Anne McLaurin and staff of CPSI Participants in focus groups

  18. Contact • Heather Richardson • 780 407-6088 • heather.richardson@albertahealthservices.ca

  19. References • Berwick, D. (2009). What 'Patient-Centered' should mean: Confessions of an extremist. Health Affairs, 28(4), w555-w565. • Buetow, S., & Elwyn, G. (2005). Are patients morally responsible for their errors?. Journal of Medical Ethics, 32, 260- 262. • Buetow, S., Kiata, L., Liew, T., Kenealy, T., Dovey, S., & Elwyn, G. (2009). Patient error: A preliminary taxonomy. Annals of Family Medicine, 7(3), 223- 231. • Conway, J., Nathan, D., Benz, E., Shulman, L., Sallan, S., Ponte, P., Bartel, S., Connor, M., Puhy, D., & Weingart, S. (2006, June). Key Learning from the Dana-Farber Cancer Institute's 10 year patient safety journey. American Society of Clinical Oncology,     Atlanta, GA. • Davidson, J., Powers, K., Hedayat, K., Tieszen, M., Kon, A., Shepard, E., Spuhler, V., Todres, D., Levy, M., Barr, J., Ghandi, R., Hirsch, G., & Armstrong, D. (2007). Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Task Force 2004- 2005. Critical Care Medicine, 35(2), 1- 18. • Davis, R., Jacklin, R., Sevdalis, N., & Vincent, C. (2007). Patient involvement in patient safety: what factors influence patient participation and engagement?. Health Expectations, 10, 259- 267. • Edgman-Levitan, S. (2004). Involving the patient in safety efforts. In M. Leonard, A. Frankel, T. Simmonds & K. Vega (Eds.), Achieving Safe and Reliable Healthcare (81-92). Chicago, IL: Health Administration Press.

  20. Engel, K., Heisler, M., Smith, D., Robinson, C., Forman, J., & Ubel, P. (2009). Patient comprehension of emergency department care and instructions: Are patients aware of when they do not understand?. Annals of Emergency Medicine, 53(4), 454- 461. • Entwistle, V., Mello, M., & Brennan, T. (2005). Advising patients about patient safety: Current initiatives risk shifting responsibility. Joint Commission Journal on Quality and Patient Safety, 31(9), 483- 494. • Entwistle, V., & Quick, O. (2006). Trust in the context of patient safety problems. Journal of Health Organization and Management, 20(5), 387- 416. • Ferguson, T. (2007). e-patients: How they can help us heal healthcare. [White Paper]. Retrieved from Society for Participatory Medicine http://e-patients.net/e-Patients_White_Paper.pdf • Kerfoot, K., Ebright, P., Rapala, K., & Rogers, S. (2006). The power of collaboration with patient safety programs: Building safe passage for patients, nurses, and clinical staff. Journal of Nursing Administration, 36(12), 582- 588. • Hibbard, J (2003). Engaging health care consumers to improve the quality of care. Medical Care, 41(1), I-61- I-70. • ISMP (2009, June 15). Inattentional blindness: What captures your attention?. Retrieved June 24, 2009 from ISMP Medication Safety Alert!, Acute Care edition Web site:     http://www.ismp.org/Newsletters/acutecare/articles/20090226.asp • Kuzel, A., Woolf, S., Gilchrist, V., Engel, J., LaVeist, T., Vincent, C., & Frankel, R. (2004). Patient reports of preventable problems and harms in primary health care. Annals of Family Medicine, 2(4), 333- 340. • Leonhardt, K., Bonin, D., & Pagel, P. (2008). Guide for developing community-based patient safety advisory councils. Rockville, MD: Agency for Healthcare Research and Quality. • Leonard, M., Frankel, A., Simmonds, T., & Vega, K. (2004). Achieving safe and reliable healthcare: Strategies and solutions. Chicago,IL: Health Administration Press.

  21. Lyons, M. (2006). Should patients have a role in patient safety? A safety engineering view. Quality Safety Health Care Journal, 16, 140- 142. • Maxfield, D., Grenny, J., McMillan, R., Patterson, K., & Switsler, A. (2005). Silence Kills. Retrieved • Plsek, P., & Greenhalgh, T. (2001). The challenge of complexity in health care. British Medical Journal, 323, 625-628. • Pronovost, P., & Faden, R. (2009). Setting priorities for patient safety: Ethics, accountability, and public engagement. Journal of American Medical Association, 302(8), 890- 891. • Rice, R. (2003). Overview and summary: Patient safety: Who guards the patient?. Online Journal of Issues in Nursing, 8(3). •  Vincent, C., & Coulter, A. (2002). Patient safety: What about the patient?. Quality Safety Health Care Journal, 11, 76- 80. • Williams, C. (2005). The identification of family members' contribution to patients' care in the intensive care unit: a naturalistic inquiry. British Association of Critical Care Nurses, 10, 6- 14.

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