Three Ways to Increase Patient Engagement
August 13, 2014 | Jane Stuckey
In the “good old days” of healthcare — and by that I’m talking about as recently as 20 years ago — caring for patients was simpler. The doctor or nurse provided the care, and the patient received it. Simple.
The language we used reflected this paradigm. For example, we referred to the patient as the consumer of care, and many hospitals routinely measured patient satisfaction as one metric of success.
Fast-forward to today, and the paradigm has changed considerably. Hospitals across the country are evolving into healthcare networks that operate around the medical home model, in which patient engagement plays a central role.
As a result, even though hospitals still conduct patient satisfaction surveys, there’s now a great deal more interest and energy around patient engagement. Granted, there’s not a lot of consensus on exactly what the term means … but there’s certainly a lot of interest!
So let’s first take a stab at defining patient engagement. At the most general level, patient engagement changes the healthcare professional-patient relationship from that of provider-to-consumer to more of a partnership. The patient is encouraged and empowered to take greater interest in and responsibility for their care, wherever the care is provided.
Emergency departments can play a role in increasing patient engagement, I’ll share my thoughts on a few of them.
But first, it’s worth pointing out that ideally, patient engagement starts well before a patient even arrives at the emergency department. If they have a primary care physician, that professional can and should play a huge role in engagement. The healthcare provider should try to make sure the patient understands their recommendations for treatment, even sharing medical records with the patient as appropriate. They can also help by motivating the patient to adopt healthier, preventive behaviors that might prevent or delay a visit to the ED.
That being said, there are specific things an ED can do to play a role in patient engagement. Here are three:
While the patient is in the ED, there are often opportunities for the healthcare provider to mention steps the patient can take to prevent another visit for the same medical situation. Like the primary care physician, the ED staff can emphasize key areas of concern by reviewing aspects of the patient’s medical records with them. In doing so, they should be aware of the many factors that can impede a patient’s willingness or ability to engage. To begin with, the ED is a stressful environment for anyone, and that alone can limit the patient’s ability to listen and focus. In addition, there are a variety of other possible factors that can play a role on the ability to engage, including the patient’s age, education level, difficulties in hearing, and language abilities, to name a few.
There are various ways to address such challenges. For example, an ED can employ design solutions such as noise-reducing materials in floors and ceilings that allow patients to focus more on what providers are saying. They could also consider modifying treatment areas to become more enclosed environments to reduce distractions and create a greater sense of privacy.
Another strategy is to acknowledge and support the helpful role that family members can play in engagement. At the most basic level, the staff can make sure that there is physical space for the family member to accompany the patient in the treatment room. For some of our clients, we’re designing treatment areas that feature a patient zone in the middle, with zones for the provider and family members to sit on either side. This design approach allows all the participants to interact on the same physical level (as opposed to the provider standing and talking down to the patient and family members), which supports the sense of partnership that underlies effective patient engagement.
On discharge, there is typically a list of topics that need to be discussed, including follow-up homecare to improve the patient’s recovery. This is one reason that when post-acute care is needed, patients benefit from having someone with them who can listen to the discharge instructions, advocate for the patient and ask questions. If an ED is not doing so already, we often recommend that they implement the practice of having a staff member contact the patient or family member the evening after the patient was seen to ask if there are any questions or other concerns that can be addressed.
In the good old days of health care, a patient wouldn’t dream of asking to see his or her chart — and I suspect that few healthcare providers would have shared it in any case. But now there’s a widespread recognition that this and other aspects of patient engagement can dramatically improve the patient’s care and outcome. For today’s healthcare providers, that’s the first step. The next is to face the related decisions, from when engagement should start and who should be involved, to how to manage and nurture it.
ABOUT THE AUTHOR Jane Stuckey RN, BSN, MS, FACHE
Drawing upon experience as a COO in both non-profit and for-profit healthcare systems and Director of Clinical Affairs for a major insurance company, Jane recommends strategies that result in improved patient, staff, and physician satisfaction, operational efficiency, and financial strength. Read more from Jane.