Patient Experience, Patient Engagement: What does it mean?

by Adena Cohen-Bearak, M.Ed., MPH- Project Manager

“Patient experience” is one of the latest buzzwords now being used in countless articles, initiatives, and websites. But what does it actually mean?

According to the Agency for Healthcare Research and Quality (AHRQ), “patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other healthcare facilities.”

Another definition is offered by The Beryl Institute, which describes itself as “the global community of practice dedicated to improving the patient experience through collaboration and shared knowledge.” The Beryl Institute describes the patient experience “as the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”

But exactly what interactions matter to patients? Press Ganey Associates, an organization that collects data from hospital patients and uses this data to improve patient experience, discovered that quality of care, clinician teamwork and care coordination, and empathy are the top patient experience factors in their analyses.

“Patient engagement” is another buzzword that is commonly used these days, but sometimes defies meaning.

“The concept of patient engagement can be defined as the desire and capability to actively choose to participate in care in a way uniquely appropriate to the individual in cooperation with a healthcare provider or institution for the purposes of maximizing outcomes or experiences of care,” report researchers from Columbia University School of Nursing and Mailman School of Public Health in a literature review of the topic.

These researchers described four common themes in the literature on patient engagement:

  • personalization
  • access to necessary resources
  • commitment to delivering quality care
  • building a positive patient-provider relationship

While access resources and quality of care are vital, two of the patient engagement themes discovered – personalization and building a positive patient-provider relationship –  are factors that can only be enhanced by improved communication and relational skills. That is exactly the work that we do here at the Institute for Professionalism and Ethical Practice (IPEP).

At IPEP, when we use the term “patient engagement”, we mean that patients and families are involved in our work – workshops and projects that enhance communication between patients, families, and clinicians – at every level, from planning to implementation, through evaluation.

For example, in the Aligning Family-Team Expectations During Surgical Consent project, our initial work involved focus groups and interviews with parents of recent surgical patients. The concerns of these parents informed the direction of the training that was ultimately delivered to surgeons in order to improve surgeon’s skill and effectiveness when talking with families prior to their child’s surgery.

Looking toward the near future, IPEP plans to “engage” families even more by offering communication training that will enhance the effectiveness of the way families communicate with clinicians. Empowering parents to express their concerns, to ask clinicians to slow down or to clarify, or to request more information about recovery times are some of the issues that may be addressed in future workshops planned for families.

Adena Cohen-Bearak is a Masters-level public health researcher with over twelve years’ experience coordinating research projects, conducting program evaluations, and specializing in qualitative research, with an additional thirteen years’ experience working in health education. After receiving her Masters of Public Health in 1999 from Boston University, she shifted her focus from health education to public health research. For the past twelve plus years, she has worked on several research projects, including: a qualitative evaluation of The School Health Index, designed to help schools improve nutrition and physical activity in students (Harvard School of Public Health); a quantitative study testing a novel telephone-based approach to improving hypertension in low-income African American adults (Boston Medical Center); and a 3-phase project on improving end-of-life care for children who die in the pediatric ICU (Education Development Center. At Harvard Catalyst/Harvard Medical School, she worked on a wide variety of population health issues ranging from childhood obesity to Hepatitis C. There, she focused on developing community-informed, evidence-based research projects to address challenging public health issues. Most recently, she has served as a consultant on several qualitative research and writing projects.

Posted in Aligning Expectations