Patient Engagement Why is it so important and what can we

do to achieve it?

Patricia F. Donehower, MSN, RNVice President of Clinical ServicesVisiting Nurse Association of Chittenden and Grand Isle CountiesVermont, United States

May 7, 2014

Patient Engagement

Getting to know Vermont2

Who is more engaged …?

Someone Looking at the Vermont Mountains

Photo credit: freephotosbank.com

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Someone Hiking the Vermont Mountains

Photo credit: Vermontvacation.com

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Engagement is the Goal

Patient engagement is the ultimate goal

An “engaged” patient works toward outcomes she/he

cares about

Individualized care results in engaged patients

It’s not a “one size fits all”

Its not a one step process

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Getting Better at Patient Engagement

Caregivers must uncover what is important to the patient

and what the patient’s strengths are

Achieving patient engagement takes skill and practice

And leadership and encouragement

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Nurse Monitors – This is Good

Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties

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Patient Monitors – This is Better

Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties

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Steps Toward Engagement

Health literacy

Communication with patient and family

Motivational interviewing

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Health Literacy

Materials appropriate to patient and patient

educational level

Everyone learns at his/her own rate

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Both are Engaged 11

Danish Moment

Communication with Patient and Family

Use teach back technique

Present information three times, three different ways

Caregivers use consistent materials

Involve family and support persons

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What is Important to the Patient?

Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties

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Mobility

Independence

Fresh air

Motivational Interviewing

Assess patient readiness

Develop patient centered goals

Strive for patient self management

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Danish Moment

PDSA for Patient Engagement

Plan

– Mr. Clausen will monitor blood glucose daily for next three days

Do

– Patients agrees and states he understands why he should test

his blood sugar

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PDSA (continued)

Study

– Nurse reviews blood glucose record and asks client how

he is doing

– Client states he tested two day/skipped one day because

he was sick and didn’t eat

Act

– Opportunity for teaching

– Ask Mr. Clausen to describe how he will handle days when

he feels sick

– Revise plan and set new goals for next three days

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Training for Patient Engagement

Teach skills and techniques of motivational interviewing

Develop a documentation system to support patient

centered goals

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Barriers to Patient Engagement

Photo credit: www.6minutes.com.au

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Isolation

Depression

Forgetfulness

How do we Measure Engagement?

Measure competency of staff

Measure number of patients who increase in readiness

Measure number of patients with self management goals

Measure patient and family perception of the plan

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Reaching Patient Engagement

Photo credit: Daria Bishop, VNA of Chittenden and Grand Isle Counties

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In Summary23

Patient engagement is the engine behind change

and improvement

Patient engagement requires time and small,

steady steps

Practice and encouragement builds engagement

– Managers understand staff needs and encourage their efforts

– Staff understand their patients’ needs and encourage their efforts

References

VNAA (Visiting Nurse Association of America)

Blueprint for Quality in Health Care (2013)

Chronic Care Management Model (Suter, 2010)

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