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Is the triple aim „better care, better health and lower cost“ an unachievable dream?

No, it is not if healthcare providers are ready to revise their operational habits.

According to a new guide from the American Hospital Association's Hospitals in Pursuit of Excellence, there is an intriguing link between the above triple aims and clients’ engagement.

Who are the clients? In this context, patients, their family and maybe their friends are. The key objective is to use the experience, expertise and insight of patients to improve care. Innovative healthcare committees describe the potential benefits of engaging patients in care as a “game changer in the transformation of the health care system”.

So, engagement of all these stakeholders is seen as essential to improve healthcare's provision. Hospitals and health systems are working to expand engagement efforts beyond bedside interventions and enlisting patients and families in the process, eliminating the need to make assumptions about what aspects of care are important to them, according to the guide.

For such provider-patient partnerships to operate effectively, providers must take several key measures, including these five outlined in the report:

  1. Recruit patient and family advisors: To choose advisors, first identify necessary skills or experiences to make sure candidates fit within the initiative. For example, recruit a patient with personal knowledge of or experience with the topic at hand or the subject of the initiative.

  2. Prepare advisors for a partnership: Once the recruitment process is complete, hospitals and health systems should provide training that incorporates the committee's history, objectives, composition and relevant protocols, according to the guide, as well as explaining workplace jargon and terminology to them.

  3. Develop a culture of engagement: To acclimate staff to the partnership, providers should take steps such as enabling ongoing feedback, tying patient and family advisor involvement to employee goals and making sure employees have the opportunity to ask questions or voice concerns about the initiative.

  4. Implement and measure improvement programs: It is vital that leaders "align the correct metric to each quality improvement group that has patient and family advisors," according to the guide. For example, project effectiveness should be measured in factors such as number of successful initiatives and their costs, patient satisfaction should be measured by HCAHPS survey scores and reduced hospital-acquired conditions for care quality/patient safety. (Note: HCAHPS is a core set of questions that can be combined with a broader, customized set of hospital-specific items.)

  5. Maintain long-term relationships: Since patient and family advisors will not be kept in the loop after the end of an improvement project in which they are involved, so it is important for providers to sustain a culture of partnership by keeping communication channels open after that point, according to the guide.

Working with patients and families will involve a cultural change that may be met with some initial resistance. Resistance can be expected from both camps: clients and employees. Leaders can overcome this situation by investing in preparing internally and externally, while explaining purpose, expected mutual benefits and how progress will be measured.

The report presents a systematic approach with a list of the key areas to address, as well as the questions to raise.

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