In today's culture, many hospitals are increasing their focus on patient-centered care—that is involving patients in their own care decisions to improve outcomes. One route that facilities are more often choosing to take is creating a patient advisory board or committee.
"There are studies that have demonstrated that an engaged patient who becomes informed and participates in their own healthcare have better outcomes," says Kathryn Leonhardt, MD, MPH, patient safety officer and medical director, care management for Aurora Health Care in Milwaukee, WI. "We realize we need to find better ways to engage our patients—if patients are not engaged it's because we as the healthcare system have not been effective in engaging them. The role of a patient advisory committee is to help us understand from the patient perspective processes and tools to facilitate that engagement."
Leonhardt was part of a team at Aurora Health Care that received a grant from the Agency for Healthcare Research and Quality (AHRQ) to create a patient advisory committee toolkit. The grant, which ran from 2005 through 2007, allowed Leonhardt to study best practices for forming and maintaining a functioning patient advisory council, and measure outcomes.
The toolkit, titled Guide for Developing a Community-Based Patient Safety Advisory Council, came out of one of 17 grants in AHRQ's Partners Implementing Patient Safety (PIPS) grant series. The series broadened the scope of AHRQs grants at the time, which were mostly focused on developing new health services research. In 2005, however, as information started to come in from earlier grants, the AHRQ decided to broaden the scope of its grants and focus on existing interventions to see if those could be shared with other hospitals across the country.
"AHRQ always thinks about patient safety as being something very local, so we knew that maybe one size didn't fit all in terms of implementation, but we thought it would be a good start to fund some projects that implemented certain patient safety interventions," says Deborah Queenan, patient safety task officer at the AHRQ. Queenan has been in charge of coordinating the PIPS grants. From there, AHRQ could determine if the project would be adaptable for many different types of facilities. The grant concerning patient advisory councils was adapted for use by hospitals in March 2008.
Using the toolkit as a resource to build a patient advisory board will help move the industry away from its previous lack of soliciting patient feedback.
"As a system on a whole, the healthcare system has not generally been developed around patient-centered care and engaging patients," says Leonhardt. "With some of the studies around understanding quality and safe outcomes, we've just now realized the importance of patient engagement. The traditional healthcare system has really been much more provider-centric."
The beginnings of a patient advisory board
Forming a patient advisory board that will be functional and provide valuable information starts with the healthcare team adequately scoping the project. This is for advisory boards that are being developed to solve a certain problem. Even for more general patient safety advisory boards, however, it's necessary to identify areas of focus.
"We kept scoping and scoping and scoping to a more narrow, specific area," says Leonhardt. "That really helped us identify the participants on the committee, and also helped us keep our project moving forward."
A patient advisory board can only be successful if the right patients and community are chosen to serve. Asking hospital staff members for recommendations should be a first stop.
"As with any relationship, many of these providers have known patients for years," says Leonhardt. Explaining to providers what the council's goals and objectives are, as well as the time commitment that will be asked of participants will help them give you their best suggestions.
Roberta Mikles, RN, director of Advocates4SafeCare, serves as a member of the patient advisory board at Sharp Memorial Hospital (SMH) in San Diego, CA. Mikles is a retired nurse who has devoted most of her time to patient advocacy and was approached by SMH to serve on its patient advisory committee in April because of a past experience she had at the facility during which her father acquired MRSA. Another good way to find valuable members to serve on an advisory board, Leonhardt says, is to reach out to patients or family members of patients who have brought forth concerns to the facility related to patient care. It's often those people who want to do what they can to make sure an error they have suffered does not occur to another patient.
Next, Leonhardt recommends conducting one-on-one interviews with potential advisory board members. It's important that potential members have specific skills, like the ability to communicate well, collaborate, knowledge of the topic/issue at hand, is from a certain demographic etc.
For more insight into how to form your own patient advisory committee, see the October issue of Briefings on Patient Safety.