“They heard our voice!” patient engagement councils in community-based primary care practices: a participatory action research pilot study

Research Involvement and Engagement

Geneviève Roch¹  Chantal Guimont²  Guy Drouin²  Isabelle Samson³  Marie-Ève Poitras⁴  Hélène Lee-Gosselin⁵  Annie Poirier⁶  Priscille-Nice Sanon⁶  Luc Vigneault⁶  Jean-François Proteau⁶  Annie LeBlanc⁷  Sabrina Guay-Bélanger⁸  Julie Haesebaert⁸  France Légaré⁹ 

[1] Centre Hospitalier Universitaire de Québec – Université Laval Research Center, Hôpital Saint-François d’Assise, Quebec City, Quebec, Canada;Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada;Clinic Manager, Quebec City, Quebec, Canada;Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada;Department of Family Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Chicoutimi, Quebec, Canada;Department of Management, Faculty of Business Administration, Université Laval, Quebec City, Quebec, Canada;Patient partner, Quebec City, Quebec, Canada;VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, G1J 0A4, Quebec City, Quebec, Canada;Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada;VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, G1J 0A4, Quebec City, Quebec, Canada;Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, Quebec, Canada;VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, G1J 0A4, Quebec City, Quebec, Canada;Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, Quebec, Canada;Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada;

关键词: Primary care;    Quality improvement;    Patient and public involvement;    Patient-centeredness;    Patient advisory council;    Participatory action research;   

DOI  :  10.1186/s40900-020-00232-3

来源: Springer

【 摘 要 】

BackgroundPatient engagement could improve the quality of primary care practices. However, we know little about effective patient engagement strategies. We aimed to assess the acceptability and feasibility of embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices.MethodsUsing a participatory action research approach, we conducted our study in two non-academic primary care practices in Quebec City (Canada). Patient-experts (patients trained in research) were involved in study design, council recruitment and meeting facilitation. Advisory councils were each to include patients and/or caregivers, clinicians and managers. Over six meetings, councils would identify quality improvement priorities and plan projects accordingly. We assessed acceptability and feasibility of the councils using non-participant observations, audio-recordings and self-administered questionnaires. We used descriptive analyses, triangulated qualitative data and performed inductive thematic analysis.ResultsBetween December 2017 and June 2018, two advisory councils were formed, each with 11 patients (36% male, mean age 53.8 years), a nurse and a manager practising as a family physician (25% male, mean age 45 years). The six meetings per practice occurred within the study period with a mean of eight patients per meeting. Councils worked on two projects each: the first council on a new information leaflet about clinic organization and operation, and on communications about local public health programs; the second on methods to further engage patients in the practice, and on improving the appointment scheduling system. Median patient satisfaction was 8/10, and 66.7% perceived councils had an impact on practice operations. They considered involvement of a manager, facilitation by patient-experts, and the fostering of mutual respect as key to this impact. Clinicians and managers liked having patients as facilitators and the respect among members. Limiting factors were difficulty focusing on a single feasible project and time constraints. Managers in both practices were committed to pursuing the councils post-study.ConclusionOur results indicated that embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices is both acceptable and feasible. Future research should assess its transferability to other clinical contexts.

【 授权许可】

CC BY