Be Prepared to Be Engaged
Patient and Family Engagement in Primary Care
Slide 1: Be Prepared to Be Engaged
Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families.
Slide 2: Speaker
Kelly Smith, PhD
Scientific Director, Quality & Safety
Co-PI, AHRQ Guide to Improve Patient Safety in Primary Care Settings by Engaging Patients and Families
kelly.m.smith@medstar.net
No financial conflicts of interest to disclose.
Slide 3: Objectives
- Review the key threats to patient safety in primary care settings and interventions to engage patients and families to improve safety.
- Describe the role and value of the Be Prepared to Be Engaged strategy in improving patient safety.
- Identify strategies for implementing the Be Prepared to Be Engaged strategy in primary care settings.
Slide 4: Guide – Project Goals
- Meaningful engagement with patients and families in ways that impact safety, not just quality.
- Based on evidence.
- Tools that are easy to use.
- Tools for practices who have not done much in this area.
Slide 5: Key Project Deliverables
- Environmental Scan.
- Four Case Studies of Exemplar Practices.
- Four Interventions to Improve Safety by PFE.
- Final Guide.
Slide 6: Key Threats & Promising Interventions
Threats to Patient Safety
- Breakdowns in communication.
- Medication management.
- Diagnosis and treatment.
- Fragmentation and environment of care.
Promising Interventions
- Shared Decisionmaking.
- Patient and Family Advisory Councils (PFAC).
- Team-based Care.
- Medication Management.
- Family engagement in care.
- Structured communication tools.
Slide 7: Patient & Family Engagement in Primary Care
Image: Circle diagram with triangle in center demonstrating how strategies to engage patients and families can link the patient, clinicians, and practice staff together in a resilient relationship. The figure also shows that external factors such as the health care system, culture, community, and environment also play a role.
Slide 8: Four Interventions
- Teach-Back
- Be Prepared to be Engaged
- Medication Management
- Warm Handoff
Slide 9: What is the Be Prepared to Be Engaged Strategy?
- Encourages patient & family engagement in three ways:
- Be ready.
- Speak-up and ask questions.
- Take Notes.
- Clinicians and staff support and reinforce use of the tools to support engagement.
Slide 10: Why Use this Strategy?
Facilitating Communication
- Unlocking shared meaning.
- Revealing contextual factors about the patient.
- Preventing communication breakdowns that can result in medical error.
Improving time management
- Enhancing information exchange between the patient and clinician.
- Sharing questions and concerns is key for timely and accurate diagnosis.
- Improving patient and family understanding of diagnosis and care plan.
Weiner et al., 2010
Slide 11: When Is Be Prepared to Be Engaged Used?
- At each visit.
- For every patient.
Slide 12: Be Prepared to Be Engaged Resources
Image: Flyers, posters, and postcards to inform patients, providers and practice staff about the Be Prepared strategy.
Link to Be Prepared materials on AHRQ project website
Slide 13: Getting Started with Be Prepared
- Step 1 - Identify a Champion and get Leadership Buy-in.
- Step 2 - Develop processes for using Be Prepared Tools.
- Step 3 - Train team members and initiate implementation.
- Step 4 - Introduce Be Prepared to Be Engaged Materials to patients.
- Step 5 - Evaluate and refine.
Slide 14: Step 1. Leadership Buy-in
- Identify a Be Prepared to Be Engaged practice champion.
- Obtain leadership buy-in and support.
- Identify a process improvement team.
- Engage a patient or two.
Slide 15: Step 2. Design Implementation
- Identify a team to help design processes for each of the Be Prepared strategy tools
- Patient Note Sheet.
- Patient Prep Card.
- Identify necessary resources for implementation.
Slide 16: Patient Prep Card
Images: Front of prep card for patients to document questions and topics they want to discuss with the provider during the appointment.
Back of card to remind patients of their next appointment.
Slide 17: Patient Note Sheet
- Supports information sharing and transfer.
- Clinicians should reinforce its use to record important information
- Medications.
- Tests and test results.
- Next steps.
Slide 18: Step 3. Orient Practice Staff
- Flyers and posters about Be Prepared for
- Practice Staff.
- Clinicians.
- Provide overview of tools and how to reinforce patient use.
Slide 19: Step 4. Orient Patients
- Orient the patient to the Be Prepared Strategy
- Patient Fact Sheet.
- Discuss expectations for use.
- Reinforce behaviors at every level of the encounter.
Slide 20: Step 5. Evaluate & Refine
- Observations.
- Team debriefs.
- Simple counts.
Slide 21: How can Be Prepared Strategy help us?
- Safety & Quality.
- Costs.
- Advancing Care Information.
- Clinical Practice Improvement.
Slide 22: How can the AHRQ PFE Guide help practices achieve success?
Image: Logic model showing PTN PFE performance dashboard domains and practice assessment tool PFE metrics. Strategy categories such as Etool, shared decision making, health literacy, patient activation, medication management, and support for patient voices can affect four PFE domains: internal PFE structure, spread to practices, PFE success stories, and innovation. There are two PFE metrics: practice can demonstrate that it encourages patients and families to collaborate and practice has a formal approach to obtaining patient and family feedback.
Slide 23: How can I get Started?
- Identify a champion leader.
- Develop a process for engaging patients and families using the intervention.
- Engage entire practice team.
- Inform patients & families.
- Evaluate & refine process.
Slide 24: Questions?
Questions?
Slide 25: References
- Lucchiari C, Pravettoni G. The role of patient involvement in the diagnostic process in internal medicine: a cognitive approach. Eur J Intern Med 2013;24(5):411-5. doi:10.1016/j. ejim.2013.01.022.
- Litchfield IJ, Bentham LM, Lilford RJ, et al. Patient perspectives on test result communication in primary care: a qualitative study. Br J Gen Pract 2015;65(632):e133-40. doi:10.3399/ bjgp15X683929.
- Elder NC, Regan SL, Pallerla H, et al. Educating seniors to be patient safety self-advocates in primary care. J Patient Saf 2008;4(2):106-12.
- Singh H. Safe and effective communication to prevent diagnostic errors. Middleton, MA: Patient Safety & Quality Healthcare; 2013. http:/ /psqh.com/safe-and-effective-communication-to-prevent-diagnostic-errors.
- Weiner S, Schwartz A., et al., Annals of Internal Medicine, 2010;153(2):pp69