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.
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
• 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
• 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
Using individual patient stories to drive
change
Political tactic
Powerful tool for engendering emotion
Use to complement clinical focus
<<Your own LHD
examples??>>
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?....
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
‘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)
“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”
Perceived Role of CEC Consumer
Advisors in Safety & Quality
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
Strategies for scaling up consumer engagement:
o Focus Groups with patients, families, staff, etc.
o Patient and Family Advisory Councils
o Patient engagement on safety, quality and other organizational
committees
o Patient participation in hiring and evaluation
o Patients as faculty
o Patients to develop/act in simulations for staff training
Culture Assessment: Listening to the voices of
patients, families and caregivers
Personalize Humanize
Demystify
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
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?
How are
you
addressing
health
literacy
barriers?
Sharing patient experiences
of care
<<Local patient/family member/carer>>
Leaders engaging staff Organisational story telling
<<Local leader>>
The power of
patient stories
What does
Dennis Quaid
have to do with
patient stories?
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
• 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
Kaiser Permanente, the largest health
maintenance organization in the U.S.,
using storytelling as part of its long-range
growth plan
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
• 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
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
Stories convey
the mission
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?
CLIFF HUGHES VIDEO
Engaging clinicians and
patients/family in improving care
<<Director of Nursing or Director of
Medical Services>>
Interactive Discussion
Delivering Training Locally
<<local educator>>
Summation
<<Chief Executive/DCG>>