Patient engagement and activation practices, or PAE, are being integrated more and more into clinical practice, but not much is known about how, or what the reaction has been among healthcare professionals. PAE can include anything from goal-setting to motivational interviewing and shared decision-making.
A team of researchers from The Dartmouth Institute for Health Policy and Clinical Practice and the Berkeley School of Public Health at UC Berkeley recently conducted a study designed to shed light on the issue.
What they found was a great deal of positive sentiment about PAE among the healthcare professionals surveyed, but much less understanding and implementation of patient engagement and activation tools and approaches.
To address this gap, the research team assessed levels of patient engagement and activation at 71 primary care sites at two ACOs -- the DaVita Healthcare Partners in Los Angeles and Advocate Healthcare in Chicago. They focused on ACOs because of their reputation for undertaking patient engagement activities.
Four dominant themes emerged during analysis of the interviews: participants recognized and were well aware of PAE terminology; they had positive appraisals of these PAE approaches; they had limited understanding of specific techniques; and they reported or acknowledged partial implementation of PAE approaches.
While most interview participants expressed positive opinions about PAE, and most (but not all) were comfortable answering questions about concepts and skills, many had limited understanding of them -- describing them in ways that didn't align with accepted definitions.
Some clinicians, for example, described "goal-setting" as the assigning, without collaboration, of clinical targets to their patients -- such as losing a certain amount of weight within a time period.
Many participants also often failed to understand the difference between general patient education materials and patient-facing tools designed to help patients understand trade-offs when comparing treatment options.
As healthcare shifts into the value-based care model, the need to engage the patient and improve care outcomes becomes ever more pressing. For larger hospitals especially, there's a need for a leader who can tap into transforming the patient experience, and some have created the Chief Experience and Innovation Officer, or CXO, for that very purpose.