Engaging Patients in Healthcare

226 Pages·2011·1.48 MB·English

by  Angela Coulter

Engaging PatiEnts in HEaltHcarE
“Angela Coulter has managed to de-mystify the concepts of patient
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engagement in healthcare in a readable, balanced, thought-provoking
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primer ... This is a ‘must read’ for students, educators, practitioners,
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managers, and policy makers.”
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Annette O’Connor RN PhD FCAHS, Emeritus Professor, University of Ottawa, Canada
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“Engaging Patients in Healthcare is the roadmap we need to guide the
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creation of the healthcare system we’ve all dreamed about – one that truly N
taps the power of patient and professional wisdom ... With this book in hand, G
perhaps we can begin ‘doing things with people instead of to them’.”
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Susan Edgman-Levitan, PA, Executive Director, Stoeckle Center for Primary Care
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Innovation, Massachusetts General Hospital, USA
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This evidence-based guide provides the first comprehensive overview of patient
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engagement and participation in healthcare. It has been written for all those
who want to understand the various ways in which patient and public T
engagement can contribute to better health outcomes. S

Angela Coulter explains the theories, models and policies at the heart of patient I
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involvement as well as giving extensive practical examples to demonstrate the

reality of involving patients. The book includes an examination of patients’ roles
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in respect of:
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• Improving care processes • Ensuring safer care A
• Building health literacy • Participating in research L
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• Selecting treatments • Training professionals
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• Strengthening self-care • Shaping services
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Clearly written, by a leading author in the field and well illustrated with data, A
examples and evidence, the book includes practical descriptions of real patient R
engagement, together with critical review and suggestions to guide future E angela coulter
developments. This guide also brings together an extensive body of international
evidence, making it the most current and original text on the market.
Angela Coulter is Director of Global Initiatives at the Foundation for Informed a
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Medical Decision Making, Boston, and Senior Researcher at the Department of
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Public Health, University of Oxford, UK. Her previous roles included Chief Executive E
of Picker Institute Europe, Director of Policy and Development at the King’s Fund, l
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and Director of the Health Services Research Unit at the University of Oxford, UK.

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MHBK037-FM MHBK037-Coulter June11,2011 13:36 PrinterName:YettoCome
Engaging patients
in healthcare
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MHBK037-FM MHBK037-Coulter June11,2011 13:36 PrinterName:YettoCome
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MHBK037-FM MHBK037-Coulter June11,2011 13:36 PrinterName:YettoCome
Engaging patients
in healthcare
Angela Coulter
Open University Press
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MHBK037-FM MHBK037-Coulter June11,2011 13:36 PrinterName:YettoCome
OpenUniversityPress
McGraw-HillEducation
McGraw-HillHouse
ShoppenhangersRoad
Maidenhead
Berkshire
England
SL62QL
email:[email protected]
worldwideweb:www.openup.co.uk
and
TwoPennPlaza,NewYork,NY10121-2289,USA
FirstpublishedOpenUniversityPress2011
Copyright©AngelaCoulter2011
Allrightsreserved.Exceptforthequotationofshortpassagesforthe
purposesofcriticismandreview,nopartofthispublicationmaybe
reproduced,storedinaretrievalsystem,ortransmitted,inanyformorby
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reprographicreproduction)maybeobtainedfromtheCopyrightLicensing
AgencyLtdofSaffronHouse,6–10KirbyStreet,London,EC1N8TS.
AcataloguerecordofthisbookisavailablefromtheBritishLibrary
ISBN10:0335242715(pb)
ISBN13:9780335242719(pb)
eISBN:9780335242726
LibraryofCongressCataloging-in-PublicationData
CIPdatahasbeenappliedfor
TypesetbyAptaraInc.,India
PrintedintheUKbyAshfordColourPress,Gosport,Hampshire
Fictitousnamesofcompanies,products,people,charactersand/ordatathat
maybeusedherein(incasestudiesorinexamples)arenotintendedto
representanyrealindividual,company,productorevent.
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ForPaddy
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Contents
Preface xiii
Acknowledgements xv
1 Thepolicycontext 1
Overview 1
Thecaseforengagement 1
Challengingprofessionaldominance 2
Promotingresponsiveness 3
Policygoals 5
Thepatient’srole 6
Trust 8
Anoteonterminology 8
Summary 10
References 11
2 Improvingcareprocesses 12
Overview 12
Policylevers 12
Patient-centredcare 14
Patients’priorities 15
Monitoringthequalityofcare 16
Substandardcare 17
Internationalcomparisons 19
Obtainingandusingpatientfeedback 19
PerceptionsofNHScare 20
Incentivizingqualityimprovements 21
Givingpatientsachoiceofprovider 22
Theprosandconsofchoice 24
Exercisingchoice 25
Strengtheningpatients’rights 26
ThePatients’Charter 27
TheNHSConstitution 27
Involvingpatientsinredesigningservices 28
Experience-baseddesign 30
Summary 31
References 31
Furtherreading 34
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viii Contents
3 Buildinghealthliteracy 35
Overview 35
Theimportanceofhealthliteracy 35
Literacyandhealthinequalities 36
Measuringhealthliteracy 36
Raisingstandards 37
Healtheducation 38
Theoriesofhealthbehaviour 39
Healthinformation 41
Informationsources 42
HealthinformationontheInternet 43
Informationquality 44
Informationastherapy 46
Impactofhealthinformation 46
Healthinthemedia 47
Impactofmediastories 49
Disease-mongering 50
Socialmarketing 52
Summary 54
References 54
Furtherreading 57
4 Selectingtreatments 58
Overview 58
Shareddecision-making 58
Practicevariations 59
Sharingexpertise 61
Clinician–patientrelationships 61
Shareddecision-makingandhealthreform 62
Expectationsofinvolvement 64
Lackofinvolvementindecisions 65
Informedconsent 66
Patientdecisionaids 68
Riskcommunication 70
Supportforparticipation 71
Advancecareplans 73
Improvingdecisionquality 75
Overcomingthebarriers 76
Summary 77
References 78
Furtherreading 82
5 Strengtheningself-care 83
Overview 83
Managingminorillness 83
Supportforself-care 84
Theimportanceofchronicdisease 85
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Contents ix
Self-managementoflong-termconditions 86
Careplanning 87
TheChronicCareModel 88
Collaborativecare 90
Chroniccaresystem 91
Theoreticalunderpinnings 92
Self-managementeducation 93
Integratedself-managementsupport 94
Supportingpeopleintheirownhomes 95
Recordaccess 97
Personalhealthbudgets 99
Evidenceonwhatworks 100
Summary 102
References 102
Furtherreading 106
6 Ensuringsafercare 108
Overview 108
Patientsafety 108
Patients’contribution 109
Choosingasafehealthcareprovider 111
Helpingtoreachanaccuratediagnosis 112
Participatingintreatmentdecision-making 112
Contributingtosafemedicationuse 113
Participatingininfectioncontrolinitiatives 114
Checkingtheaccuracyofmedicalrecords 115
Observingandcheckingcareprocesses 116
Reportingadverseevents 117
Practisingeffectiveself-care 118
Advocacyandfeedback 118
Whenthingsgowrong 120
Summary 121
References 121
Furtherreading 125
7 Participatinginresearch 126
Overview 126
Theimportanceofpatients’roleinresearch 126
Participatoryresearch 127
Determiningresearchpriorities 128
Commissioningresearch 130
Designingstudies 130
Recruitingparticipants 131
Measuringhealthoutcomes 133
Gatheringandanalysingdata 135
Disseminatingandusingresearchfindings 136
Supportinginvolvementinresearch 138