Patients and Patient Experiencethe right structure and the right tool

Adam Thompson

NQC Peer Consultant

February 5, 2013

Welcome and Introductions

3

History of Involvement

• Fingerprints – The Denver Principles; Authors and Souls

• Blueprints – The Ryan White Program; Drafters and

Supporters

• Nuts and Bolts – Community Planning Members

• Betterment – Quality Improvement Advocates

4

Patient Activation

“A fundamental belief underlying efforts to

reshape health care institutions and systems is

that patients who are activated to participate in

their own health care are more likely to adopt

healthy behaviors leading to improved health

outcomes.”

(van Korff et al. 1997; Bodenheimer et al. 2002a, b’ Mosen et al. 2007)

5

Four Stages of Patient Activation

• Patients:

Play important roles in self-management

Possess knowledge needed to manage their

health

Act by using their skills and behaviors to

maintain well-being

Manage stress and stay the course

6

Champions and Experts

• Champion

(noun) - a person who vigorously supports or defends a

person or cause

• Expert

(noun) - a person who is very knowledgeable about or

skillful in a particular area

(adjective) - having or involving a great deal of knowledge

or skill in a particular area

7

Identifying a Champion

• Draw from your ENTIRE patient population

• Choose patients who

Are self-managing patients

Demonstrate prosocial characteristics

Are comfortable with and have access to technology

Are able to commit to a defined period of involvement

Can work collaboratively

Express a desire to learn new skills

• The “squeaky wheel” might not be the best choice

8

Dimensions of Quality

Technical Quality

Provider Perception

of Quality of HIV

Care

Experience Quality

Patient Perception of

Quality of HIV

Care

Leonard Berry, Texas A&M University, IHI conference 2001

9

Preparing a Champion

• Recognition of patient experience as only a foundation

• Identification of Capacities for Quality Management

Performance Measurement

Computational Skills

• Statistical Calculations

• Evaluating Data

Quality Improvement & Management Models

• Advocacy Skills

10

Developing an Expert

• Adult Learning Theory

• Facilitation of Disenfranchised Learners

Math

Science

• Building Capacity of Non-Medical Professionals

Performance Measurement

Data Analysis

Quality Management

11

Patient Involvement in Quality Management

The goal is to incorporate

Patients and Patient Experiences

into quality improvement activities.

Patients and Patient Experience

13

Question

How are you currently utilizing

patients and/or patient experience

in your systems or service delivery

improvement activities?

14

What am I trying to do?

15

Patient Involvement Structures

Consumer Advisory Boards

Statewide Planning Bodies

Regional Planning Bodies

Clinical Quality Teams

Organizational Boards

• Statewide

Planning Groups

Advisory Groups

• Regional

Consortia

Planning Councils

• Local

CABs

Quality Teams

Organizational Boards

16

Qualifications, Expectations, and Selection

Consumer Advisory Board

• Qualifications

Meeting Participation

Person Living with HIV

• Expectations

Provide Input and Feedback

Share Personal Experience

• Make-up

Demographic Based

Quality Management Team

• Qualifications

Meeting Participation

Person Living with HIV

Knowledge and Skills of QM

• Expectations

Provide Input and Feedback

Support QI Activities

Team Responsibilities

• Make-Up

Skills Based

17

Tools for Collecting Patient Experience

Assessments

Focus Groups

SurveysTown Halls

One on One

• Solicitation Methods

Needs Assessments

Focus Groups

Surveys

Key Informant Interviews

Community Town Halls

Patient-Provider

Conversations

18

Patient Experience

19

Utilizing Structures and Tools Effectively

20

Planning for Effective Patient Involvement

• Structures

What skills, traits, or qualities will the patient need to be

involved within this structure?

What structure will help us achieve our goal(s)?

• Tools

What kind(s) of information am I seeking?

What tool(s) will give me the best information?

Training of Consumers on Quality

(TCQ) Activity: Decision-Making

22

You Decide!

• Using the Decision-Making Model Handout, make an

estimate of how many candies you think there are in the jar.

• You will make an estimate of the number of candies a total

of four times.

• Each round you will make an estimate with more of your

peers as part of the process.

• You must each round only make a single estimate per group!

23

Consensus Decision Making

• Process towards decision is collaborative

• Environments of trust, team-attitudes, and relationships can

best adapt this style

• Actively seeks the opinions of all persons in the decision-

making process

• Engaging process that relies on series of votes in order to

establish a majority and/or stand-aside minority votes

• Process can be easily undermined by malevolent use of block

votes

24

Key Points

• Incorporating Patients and Patient Experience requires

planning and understanding.

• There are many structures and tools that can help us improve

our services.

• Different structures require different skills and people to

work effectively.

• Using more than one tool helps us to get a better picture of

our services and systems.

• Using the structures and tools in the right way can help us to

better our improvement processes.

National Quality Center (NQC)

212-417-4730

NationalQualityCenter.org

Info@NationalQualityCenter.org