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Consumer partnerships that work. <<Local Leader involved in consumer engagement>>. The Challenge for health services. Recent survey of over 3500 hospital/health senior executives across Australia. 

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consumer partnerships that work

Consumer partnerships that work

<<Local Leader involved in consumer engagement>>

the challenge for health services
The Challenge for health services
  • Recent survey of over 3500 hospital/health senior executives across Australia. 
  • From the survey, 39.2% of the respondents said that Partnering with Consumers is by far the most challenging aspect of the NSQHS standards. 
  • Survey respondents: public 75.3%, private 24.7%.

Source: Criterion

models for consumer partnerships
Models for Consumer Partnerships
  • Patients as Advisors (PFAC, etc)
  • Patients as Teachers (service design & professional education)
  • Patients Accelerating Practice Change
    • Service improvement initiatives with priorities identified through patient feedback
  • Patients informing Policy development
consumer partnerships
Consumer partnerships
  • Determine attributes: ‘fit for the job’
    • Aim to improve patient care through positive contribution
    • Objective and constructive manner
    • Willing to speak up -in the right place in their journey
  • Adequately prepared – orientation;expectations
  • Cultural fit – organisation/committee believes consumer involvement is integral to QI
  • Responsive: suggestions acted upon
power of the n 1
Power of the n=1
  • Using individual patient stories to drive change
  • Political tactic
  • Powerful tool for engendering emotion
  • Use to complement clinical focus
challenges
Challenges?
  • Squeaky wheel syndrome
  • Advocacy Vs sharing experience
  • Supporting ‘seat at the table’
  • Which ‘consumers’ have the time?
which core action item in standard 2 had the highest not met rate
Which core action item in Standard 2 had the highest ‘Not Met’ rate?....
  • 2.2.2 Consumers actively involved in decision making about safety & quality
  • 49% - Highest ‘not met’ rate in ACHS pilot audit of standards with 46 hospitals
building partnerships
Building partnerships
  • ‘Fear of the unknown’ by providers is the greatest barrier to involving patients in safety improvement work
  • Robert Wood Johnson Foundation
consumer engagement in safety quality at cec s2 2
Consumer engagement in Safety & Quality (at CEC) (S2.2)
  • “The consumer tends to see the problem and solution so much more simply and they ask reasonable questions – whereas the healthcare professional tends to drown in the complexity / what cannot be done”
  • “Helps to focus a clinical group on the purpose of initiatives”
access to orientation and training for consumers s2 3
Access to orientation and training for consumers (S2.3)
  • Consumer Safety & Quality Training
  • – open to LHD Consumers on S&Q Committees since 2012
caregivers and patients co creating a shared agenda for improvement
Caregivers and patients co-creating a shared agenda for improvement

Strategies for scaling up consumer engagement:

  • Focus Groups with patients, families, staff, etc.
  • Patient and Family Advisory Councils
  • Patient engagement on safety, quality and other organizational committees
    • Patient participation in hiring and evaluation
    • Patients as faculty
    • Patients to develop/act in simulations for staff training
culture assessment listening to the voices of patients families and caregivers
Culture Assessment: Listening to the voices of patients, families and caregivers

Personalize Humanize Demystify

the generic patient
The ‘generic’ patient?
  • About 60% of Australians (15-74yrs) have limited health literacy*
  • 1 in 3 NSW residents were born overseas
  • 1 in 4 speak a language other than English at home

*2006 Adult Literacy and Life Skills Survey, ABS

slide17

Consumer feedback on patient information publications (S2.4)What is your health services policy on health literacy? How are you assessing and breaking down barriers for patients?

sharing patient experiences of care

Sharing patient experiences of care

<<Local patient/family member/carer>>

slide24

The power of

  • patient stories
story power the secret weapon
Story Power: The secret weapon
  • Quaid D, Thao J, Denham C. (2010)
  • Journal of Patient Safety 6(1): 5-14.
  • Study of 675 hospitals where safety leaders showed staff a patient story highlighting failed communication & team work.
  • 85% perceived that viewing the patient story had resulting in the saving of lives or had a positive effect on patient care
  • Stories can inspire improvements in quality & safety
experiential knowledge
Experiential knowledge
  • Of patients – stories and narratives
  • Of carers – culture of ‘health talk’ in families*
  • Of health care professionals – sharing stories, tacit learning models
  • *(Lindenmeyer A (2011) The family is part of the treatment really. Health. 15: 401-415.)
leading organisations
Leading organisations
  • Kaiser Permanente, the largest health maintenance organization in the U.S., using storytelling as part of its long-range growth plan
slide29

In every story I have heard, good teachers share one trait: a strong sense of personal identity infuses their work.

  • - Parker J. Palmer
great leaders use personal stories
Great leaders use personal stories
  • Howard Gardner – Leading Minds
  • Couch personal stories in the language of the past to gain commitment
  • Issues of identity
  • Connect with original values
the story is central
The story is central
  • Leaders tell stories about themselves and their groups/clans, about where they are coming from and where they are heading, about what is to be feared, struggled against and dreamed about.
  • Howard Gardner
slide32

Stories convey

  • the mission
sharing a patient based vision
Sharing a patient-based vision
  • Illustrate your values in your personal story
  • Gain staff commitment (beyond a ‘control’ culture)
  • Access discretionary effort by staff
  • Reconnecting staff with ‘original values’
    • Why did you start to work in health care?
engaging clinicians and patients family in improving care

Engaging clinicians and patients/family in improving care

<<Director of Nursing or Director of Medical Services>>

delivering training locally

Delivering Training Locally

<<local educator>>

summation

Summation

<<Chief Executive/DCG>>