patient activation & engagement basics institute for clinical systems improvement beth webb,...
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Patient Activation & Engagement Basics
Institute For Clinical Systems Improvement Beth Webb, Project Manager, RN, BA
May 29, 2013
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Objectives
• Identify the vital role that patients and families play in ensuring health and well-being as well as facilitating better health outcomes•Define the difference between patient activation & patient engagement•Identify three patient engagement strategies and tools
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Patient and family centered care
• A partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care
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Patient-Centered Means….
• Respect and dignity• Information sharing• Participation• Collaboration
~Institute for Patient and Family Centered Care
www.ipffc.org
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Patient-Centered Means….
• Start where the patient is• Encourage realistic steps– creating
opportunities to experience success• Build on strengths • Use measurement to assess and to track
progress
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Why be Patient-Centered?
•Total cost of care for patients with patient centered care is 48.63% less than those without1
•Patient satisfaction can increase 3% or more when patient centered care is introduced2
•70% of one MN health plan’s insured is getting treatment from a provider under a TCOC agreement
1Bertakis, K, Azari, R, Patient Centered care is Associated with Decreased Health Care Utilization, JABFM 24(3):229-239 (2011)2 Charmel, P, Frampton, S, Building the business case for patient-centered care, Healthcare Financial Management, March 2008
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Two Experts in the Room
Provider’s Expertise1 Patient’s Expertise
Diagnosis Experience of illness
Disease Etiology Social circumstances
Prognosis Attitude to risk
Treatment options Values
Outcome possibilities Preferences
Coulter, A., Collins, A., Making Shared Decision-Making a Reality, The Kings Fund 2011
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Patient Activation
• Patient activation—an “individual’s” knowledge, skill, and confidence for managing his/her own health and health care
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Importance of Activation
• If people don’t understand their role, they aren‘t going to take action, they aren’t going to look for or take in new information
• If people don’t feel confident, they are less likely to be pro-active
• This appears to be true regardless of condition
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Value of Activation
Research consistently finds that those who are more activated are:
– Engaged in more preventive behaviors
– Engaged in more healthy behaviors
– Engaged in more disease specific self-management behaviors
– Engaged in more health information seeking behaviors
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Value of Knowing Activation Level
To know who needs more support To target the types of support and
information patients and consumers need To evaluate efforts to increase activation To evaluate the quality of care To build the evidence base
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Activation is developmental
Source: J.Hibbard, University of Oregon
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Levels of Participation
• International Association of Public Participation
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New Insights
• Can identify “next steps” more appropriately
• Presently asking too much of too many
• When we focus on the more complex and difficult behaviors– we discourage the least activated
• Start with patient’s values—minimize number of requests
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Increasing Activation
• Tailored coaching
• Including brief coaching in the clinical setting– with follow-up
• Segmentation approaches and differential allocation of resources
• Care transitions and reducing hospital re-admissions
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Patient and family engagement
• Patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system—direct care, organizational design and governance, and policy making—to improve health and health care.1
1Health Aff February 2013 vol. 32 no. 2 223-231
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Tools for Partnering with Patients, families and caregivers
• Understanding Behavior Change– Stages of Change (Prochaska)
• Active Listening• Coaching• Motivational Interviewing• Teach back• Shared Decision Making
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Questions ?
Upcoming RARE Events….
• Stay tuned for the next RARE Conversation in June 2013!
Future webinars…
•To suggest future topics for this series, Reducing Avoidable Readmissions Effectively “RARE” Networking Webinars, contact Kathy Cummings, [email protected]