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Challenges and promising solutions to engaging patients in healthcare implementation in the United States: an environmental scan.
Woodward, Eva N; Castillo, Andrea Isabel Melgar; True, Gala; Willging, Cathleen; Kirchner, JoAnn E.
Afiliación
  • Woodward EN; VA Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Drive, Building 11, North Little Rock, AR, 72114, USA. eva.woodward2@va.gov.
  • Castillo AIM; Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA. eva.woodward2@va.gov.
  • True G; VA Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Drive, Building 11, North Little Rock, AR, 72114, USA.
  • Willging C; Graduate School, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA.
  • Kirchner JE; South Central Mental Illness Research Education and Clinical Center, Southeast Louisiana Veterans Health Care System, 2400 Canal St, New Orleans, LA, 70119, USA.
BMC Health Serv Res ; 24(1): 29, 2024 Jan 04.
Article en En | MEDLINE | ID: mdl-38178131
ABSTRACT

BACKGROUND:

One practice in healthcare implementation is patient engagement in quality improvement and systems redesign. Implementers in healthcare systems include clinical leadership, middle managers, quality improvement personnel, and others facilitating changes or adoption of new interventions. Patients provide input into different aspects of health research. However, there is little attention to involve patients in implementing interventions, especially in the United States (U.S.), and this might be essential to reduce inequities. Implementers need clear strategies to overcome challenges, and might be able to learn from countries outside the U.S.

METHODS:

We wanted to understand existing work about how patients are being included in implementation activities in real world U.S. healthcare settings. We conducted an environmental scan of three data sources webinars, published articles, and interviews with implementers who engaged patients in implementation activities in U.S. healthcare settings. We extracted, categorized, and triangulated from data sources the key activities, recurring challenges, and promising solutions using a coding template.

RESULTS:

We found 27 examples of patient engagement in U.S. healthcare implementation across four webinars, 11 published articles, and seven interviews, mostly arranging patient engagement through groups and arranging processes for patients that changed how engaged they were able to be. Participants rarely specified if they were engaging a population experiencing healthcare inequities. Participants described eight recurring challenges; the two most frequently identified were (1) recruiting patients representative of those served in the healthcare system; and (2) ensuring processes for equitable communication among all. We matched recurring challenges to promising solutions, such as logistic solutions on how to arrange meetings to enhance engagement or training in inclusivity and power-sharing.

CONCLUSION:

We clarified how some U.S. implementers are engaging patients in healthcare implementation activities using less and more intensive engagement. It was unclear whether reducing inequities was a goal. Patient engagement in redesigning U.S. healthcare service delivery appears similar to or less intense than in countries with more robust infrastructure for this, such as Canada and the United Kingdom. Challenges were common across jurisdictions, including retaining patients in the design/delivery of implementation activities. Implementers in any region can learn from those in other places.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención a la Salud / Instituciones de Salud Aspecto: Determinantes_sociais_saude / Equity_inequality / Implementation_research Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención a la Salud / Instituciones de Salud Aspecto: Determinantes_sociais_saude / Equity_inequality / Implementation_research Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido