Natalie Truesdell, author of the study, is a consultant with John Snow, Inc, which has been providing evaluation services to the MeHAF Integration Initiative since 2009.
If the goal of health care organizations is better health outcomes for their clients, then patient engagement is key. Health care providers who are engaging patients consider the patients' needs, preferences and perspectives when care decisions are being made. Patient engagement leads to higher patient satisfaction and lower costs.
Patient engagement has been a central component of the projects funded through MeHAF's Integration Initiative, which seeks to improve the integration of primary health care with behavioral health care. MeHAF believes that engaging patients means ensuring they are active participants in their own care and that patients' perspectives are contributing to decisions made at higher levels in the organization and the health care system.
Over the course of this initiative, our grant partners have collected experiences and insights into improving patient engagement. We have gathered those experiences into a case study that describes strategies used by diverse organizations to engage patients at each level of health care decision-making.
At the level of the individual patient's experience and his/her experience with the clinic, the key to patient engagement is a trusting relationship between patient and staff. The experience starts when the patient is welcomed into the office by reception staff. One program that trained front desk staff at primary care practices on how to improve their interactions with patients with mental health conditions helped everyone at the practice to understand his/herown role as part of a team delivering patient-centered care.
Beyond the individual level, patients can provide a fresh and honest perspective on how to improve overall health care services and policy. To include patients in the decision-making process at a systems level and an organizational level, grantees worked to establish patient advisory groups where patients can bring new insight to day-to-day processes as well as to new initiatives. Patients traditionally have not had an ongoing and institutionalized role as advisors or decision makers at this higher level. The grantee organizations experimented with different methods of identifying participants for advisory roles, ways to encourage them to participate, formats and agendas for advisory groups.
As an example of how the advisory groups work, patients in one group brought up their feelings of being considered a "bad patient" due to forgetting medications or not following advice. This prompted behavioral health providers to have more frequent conversations with primary care providers on how to coach and work with patients, giving them tools to help mitigate the patients' sense of failure.
Such advisory groups can also take on the role of educators and advocates of integration to the community and to providers. Members of one grantee organization speak to patients and providers at events around the state about their experiences as behavioral health patients and the benefits of integrated care. Through these events, they are also working to address the issue of stigma in both the provider and the patient communities.
See the case study [UPLOAD REPORT] for practical recommendations on how to engage patients at the individual level, clinical microsystem level, and the organizational and health care system environment levels.
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