Selecting Engagement Strategies
This Change Package groups engagement strategies into four categories: Collaboration, Co-ownership, Communication and Consultation. Health care organizations are often already familiar with the Communication and Consultation strategies and while these approaches are a reasonable starting point for organizations with little experience in engagement efforts, organizations truly dedicated to implementing person-centered engagement must work towards implementing Co-Ownership and/or Collaboration based strategies.
Key actions to take in deciding which engagement strategies make most sense for your organization
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Conduct key informant interviews with patients, community leaders, members of leadership and frontline staff from an array of departments (e.g., quality improvement, provider groups, communications) to identify patient care issues of most concern to each group. Make sure to inquire about the types of strategies the organization has used previously and seek to understand the experience.
Pro Tip: Embrace Negative Feedback
Many organizations struggle with accepting negative feedback. The organizations interviewed for the accompanying case studies (Trinity Health, HRHCare, and Children’s Mercy Kansas City) all highlighted the importance of seeking out and listening to negative feedback as key to improvement. This was so important that each organization made it a point to specifically seek out and engage patients with negative experiences.
“Sometimes, you get feedback that is very uncomfortable, and the ego balloon is popped. It is easier to just not do it. But, if you are willing to take the feedback, it can set you free as an organization and culture.” – Paul Kempinski, Children’s Mercy President & CEO
- Supplement key informant interviews with survey tools to get a broader sense of need and of experience.
- Review consumer feedback, especially negative feedback, to better understand the kinds of issues that consumers are most concerned with and how that compares with the experiences of the consumers and family members on the planning workgroup and areas that organization leadership and frontline staff have identified as issues.
- Employ approaches across several categories of engagement (communication, consultation, collaboration and co-ownership) in order to involve consumers and families with different perspectives, availability, skills and interests.
- Develop feedback mechanisms to communicate how the information provided by patients, family members, and the community influenced a given decision. This should be a priority regardless of the engagement approach used because demonstrating how feedback is used is key to maintaining participation in any engagement strategy.
- Get started! Start with one strategy and build upon it, as staffing allows and as internal buy-in grows.
- Build a budget. See the Determining Resource Requirements section for additional information on determining resource needs and budgeting.
- Get leadership approval!
Considerations for Inpatient vs. Outpatient Settings
In general, inpatient and outpatient facilities can use many of the same engagement strategies; however, there are factors intrinsic to each setting that could steer toward the specific engagement approach best to employ.
- Inpatient Factors: Patients in inpatient settings are, by default, interacting with the health care organization on a full-time basis during their stay. Inpatient admissions for acute or chronic conditions are stressful for patients and their families. Those developing engagement strategies should be mindful of this and create a variety of appropriately sensitive modes for engagement. This could include individual-level engagement activities such as person- or family-centered rounding focused on identifying opportunities to improve the immediate care experience or built around support for specific serious or chronic conditions, as well as collaboration and co-ownership strategies. In terms of resource requirements, inpatient settings tend to have an advantage over outpatient settings in that they generally have access to food service and meeting space that can be used to support in-person meetings.
- Outpatient Factors: Outpatient organizations (especially primary care providers) often have the advantage of having developed long-term relationships with patients, facilitating frequent engagement opportunities. That said, outpatient care also covers a wide range of needs from simple wellness visits for people with no underlying conditions, to complex care for individuals with multiple chronic conditions. These factors can make it challenging to engage individuals with infrequent health care needs or to establish a single strategy that is responsive to the wide range of patients being served. Outpatient care organizations should develop several engagement opportunities built around geographic locations, specific conditions, or areas of interest and ranging from open-door listening sessions to formal advisory councils. From a resource requirement perspective, outpatient organizations also may find it more difficult to secure meeting space or food service as compared to inpatient settings.
Self-Assessment Questions
On a scale of 1 to 5 (with 1 indicating “strongly disagree” and 5 indicating “strongly agree”), rate your organization’s performance on the following questions:
- The planning team engages with consumers, organization leadership and frontline staff to identify the issues each group is most interested in and concerned about.
- Leadership at my organization looks to both positive and negative patient feedback to identify opportunities to improve.
- Our organization-level plan for engagement includes a variety of ways for patients to engage depending on their availability and level of interest.
- Our organization-level plan for engagement includes strategies that support the two-way flow of information and long-term relationship building with a group of patient advisors (i.e., collaborative and/or co-ownership strategies).
- Our leadership team is enthusiastic about the proposed engagement strategies and actively promotes them within and outside the organization.
Resources
- Foundational Materials
- American Institutes for Research: Patient and Family Engagement in Health Care Practice and Research
- Institute for Patient and Family Centered Care: Advancing the Practice of Patient Centered Care in Hospitals
- Institute for Patient and Family Centered Care: Advancing the Practice of Patient Centered Care in Ambulatory Care
- Planetree: Leadership Rounding Tool
- Planetree: Long-Term Care Improvement Guide
- Planetree: Family Engagement Strategies Organizational Gap Analysis Tool
- Planetree: Patient and Family Engaged Care Framework
