Action 2.06

Partnering with patients in their own care is integral to the delivery of safe and high-quality person-centred health care. Ensure that effective processes are in place to support clinicians to partner with patients or their substitute decision-maker in the planning, communication, goal-setting and decision-making relating to their current and future care.

Review current systems for supporting clinicians and patients to be partners in care

If systems are already in place to support clinician and patient partnerships, review the strategies outlined below and consider any additions or updates.

If the organisation does not have systems in place to support partnerships between clinicians and patients, use the strategies outlined below to develop or adapt policies and processes for partnering with patients in their care.

Create a supportive organisational culture

Supportive organisational climates are vital for achieving person-centred care, in which partnerships between clinicians and patients become the established norm. Strategies may include:

• Engaging leadership and governing bodies to act as champions for partnerships between clinicians and patients
• Incorporating the importance of clinician and consumer partnerships into the organisation’s strategic planning, vision and goals
• Engaging consumers in organisational governance and strategic planning to support organisational redesign (see Action 2.01 for guidance)
• Providing enough resources to support clinicians to partner with patients in their care
• Providing education and training to equip clinicians to partner with patients in their care; further information on education and training for clinicians is provided in Action 2.07.¹

Enable communication and knowledge exchange between clinicians and patients

Patients can be partners in their own care in many ways, including shared decision making, self-management of their condition and personalised care planning. For these partnerships to be meaningful, both the clinician and the patient must feel trusted and respected. Good communication is vital to foster this trust and respect, and drive clinician and patient partnerships.¹

Use the following strategies to encourage communication and knowledge exchange between clinicians and patients:

• Review the current admissions process to see what information is provided to patients and how that information is given; identify any communication barriers and areas for improvement, and implement solutions to overcome these; consider engaging consumers in this review process by holding informal discussions with patients in waiting rooms, or discussing the admission process during a consumer advisory group or focus group
• Provide consumers with access to information and resources in a format that meets their needs; this may include
  • general information about their health, condition and healthcare arrangements
  • information and tools about how they can be involved in their own care
  • information that has been developed specifically for them
• Provide patients with timely and open access to their healthcare record, test results and other clinical information relevant to their care
• Encourage clinicians to create an environment in which patients feel confident asking questions, and in which clinicians respond positively to patient needs; this may involve speaking with patients in a neutral environment, away from the clinical setting
• Use technology such as telehealth, and mobile and tablet apps to interact and share information with patients before, during and after their care, especially as a strategy for facilitating clinician and patient partnerships across long distances; ensure that any healthcare records transmitted electronically are encrypted or aligned with privacy regulations
• Develop a policy and procedure to support active engagement of patients during bedside rounding and clinical handovers
• Support patients to take part in shared decision making with decision support tools, such as information sheets, pamphlets and videos that provide structured information about their health options
• Implement self-management of certain aspects of care, such as medicine use, to encourage engagement.^2-5

The Agency for Healthcare Research and Quality provides practical advice for improving clinician and patient communication, including tools to educate consumers on how to be involved in their own care.

The SA Health Guide for Engaging with Consumers and the Community provides a tool to help clinicians encourage questions from their patients.

The Commission and Healthdirect Australia developed Question Builder, a free web-based tool to help consumers prepare for a visit to the doctor. In addition, the Commission’s Top Tips for Safe Health Care can help consumers, families, carers and other support people get the most out of their health care.

Develop policies and procedures to guide care planning in partnership with patients

Involve patients in the development of any current and future care planning, such as:

• Inpatient treatment and recovery planning
• Treatment and preventive health strategies for ongoing care outside the health service organisation
• Advance care planning (see Action 5.09).

Strategies for involving patients in care planning may include systematically discussing patient preferences for care during admission consultations, and at regular times during their care. This may be facilitated by including patients in bedside rounding and clinical handovers.5

Develop meaningful measures to monitor success

Monitoring and measuring the success of clinician and patient care partnerships is important for ensuring that systems are relevant and useful to consumers and the organisation.^{1, 5}

Strategies for monitoring and measuring the success of the systems may include:

• Collecting informal feedback from patients in waiting rooms and during rounds
• Collecting formal feedback from consumers through submissions and events, such as focus groups or community meetings
• Surveying patients to self-report on their experience and satisfaction with the level of engagement they had in their care.

Use the outcomes of these evaluations to set realistic goals for improving partnerships between clinicians and patients.

Several established measures and tools can be used to capture patient-reported outcomes, including:

• The Point of Care Foundation’s Patient and Family-Centred Care toolkit, which provides guidance and tools to measure consumer partnerships
• The Agency for Healthcare Research and Quality CAHPS hospital surveys, which ask patients to report on their experiences with a variety of healthcare services.

For guidance on undertaking consultations and surveys, see the Victorian Government’s Engagement Toolkit.

Tools and resources to help guide the integration of clinician and patient care partnerships include:

• The NSW Agency for Clinical Innovation’s Designing Change Projects model, which provides a simple methodology and tools to support health service organisations through the change process
• Planetree’s improvement guide and accreditation scheme that demonstrates whether a health service organisation has fulfilled its goals for person-centred care
• The Institute for Patient- and Family-Centered Care’s getting started guide for advancing the practice of patient- and family-centred care in hospitals.

Partnering with patients in their own care is integral to the delivery of safe and high-quality person-centred health care. Day procedure services will generally engage with patients for a short time, and patients may have discussed their procedure with the referring clinician before admission. The service should still have systems in place to support clinicians to partner with patients in any planning, communication, goal-setting and decision-making related to the care they receive.

Review current systems for supporting clinicians and patients to be partners in care

If systems are already in place to support partnerships between clinicians and patients, review the strategies outlined below, and consider any additions or updates.

If the organisation does not have systems in place to support partnerships between clinicians and patients, use the strategies outlined below to develop or adapt policies and processes for partnering with patients while they receive care at the day procedure service.

Create a supportive organisational culture

Supportive organisational climates are vital for achieving person-centred care, in which partnerships between clinicians and patients become the established norm. Strategies may include:

• Engaging leadership and the governing body to act as champions for partnerships between clinicians and patients
• Providing enough resources to support clinicians to partner with patients in their care
• Providing education and training to equip clinicians to partner with patients in their care; further information on education and training for clinicians is provided in Action 2.07.¹

Encourage communication and knowledge exchange between clinicians and patients

Patients can be partners in their own care in many ways, including shared decision making and self-management of their condition. For these partnerships to be meaningful, both the clinician and the patient must feel trusted and respected. Good communication is vital to foster this trust and respect, and drive clinician and patient partnerships.¹

Use the following strategies to encourage communication and knowledge exchange between clinicians and patients^2-5:

• Review the current admissions process to see what information is provided to patients and how that information is given; identify any communication barriers and areas for improvement, and implement solutions to overcome these; consider engaging consumers in this review process by holding informal discussions with patients in waiting rooms.
• Provide consumers with access to information and resources in a format that meets their needs; this may include
  • general information about their health, condition and procedure
  • information and tools about how they can be involved in their own care
  • information that has been developed specifically for them.
• Encourage clinicians to create an environment in which patients feel confident asking questions, and in which clinicians respond positively to patient needs; this may involve speaking with patients in a neutral environment, away from the clinical setting.
• Use technology such as telehealth, and mobile and tablet apps to interact and share information with patients before, during and after their care, especially as a strategy for facilitating clinician and patient partnerships across long distances; ensure that any healthcare records transmitted electronically are encrypted or aligned with privacy regulations.
• Support patients to take part in shared decision making with decision support tools, such as information sheets, pamphlets and videos that provide structured information about their health options.

The Agency for Healthcare Research and Quality provides practical advice for improving clinician and patient communication, including tools to educate consumers on how to be involved in their care.

The SA Health Guide for Engaging with Consumers and the Community provides a tool to help clinicians encourage questions from their patients.

The Commission and Healthdirect Australia developed Question Builder, a free web-based tool to help consumers prepare for a visit to the doctor. In addition, the Commission’s Top Tips for Safe Health Care can help consumers, carers, families and other support people get the most out of their health care.

Develop meaningful measures to monitor success

Monitoring and measuring the success of clinician and patient care partnerships is important for ensuring that systems are relevant and useful to consumers and the organisation.^{1, 5}

Strategies for monitoring and measuring the success of the systems may include:

• Collecting feedback from patients in waiting rooms and during rounds
• Surveying patients to self-report on their experience and satisfaction with the level of engagement they had in their care.

Use the outcomes of these evaluations to set realistic goals for improving partnerships between clinicians and patients.

For guidance on undertaking consultations and surveys, see the Victorian Government’s Engagement Toolkit.

The Point of Care Foundation’s Patient and Family-Centred Care toolkit also provides guidance and tools to measure consumer partnerships.

Examples of evidence

Select only examples currently in use:

• Policy documents for partnering with consumers in their care, including communication and interpersonal skills, shared decision making, and planning current and future care
• Training documents about communication and interpersonal skills, partnering with consumers and shared decision making
• Tools to support shared decision making, care planning and development of goals of care
• Audit results of healthcare records to see whether
  • information was provided to patients and carers about care options
  • patients and carers were involved in preoperative assessment, including information about the impact that surgery or the intervention will have on them post-discharge (for example, when they can fly, drive, return to work or sport)
  • a plan for care was developed with patients and clinicians, and provided to patients to review, sign and receive as a copy relating to their treatment
  • patients and carers were involved in decision-making (for example, case conference records)
  • patients and carers could choose the dates for surgery, if possible
  • patients could choose their own music, reading material, comforters and so on
  • carers were able to stay with patients throughout their treatment, if they chose to
  • patients and carers were involved in discharge planning
  • patients were engaged in developing goals of care (for example, in an advance care plan)
• Patient information packages or resources about care options that are available for patients in different languages and formats, consistent with the patient profile
• Results of patient and carer experience surveys, and actions taken to deal with issues identified regarding participation in making decisions about their care
• Observation of patients and carers taking part in making decisions about their care
• Feedback from patients and carers about their experiences in shared decision making and care planning.

Partnering with patients in their own care is integral to the delivery of safe and high-quality person-centred health care. To ensure that effective systems are in place:

• Develop policies and processes (or review existing policies and processes) to involve patients or their substitute decision-maker in planning, communication, goal-setting and decision-making for their current and future care, and review workforce compliance with these policies and processes
• Set up mechanisms to support communication between clinicians and patients or their substitute decision-maker
• Periodically review the systems for partnering with patients or their substitute decision-maker in their own care.

Create a supportive organisational culture

Supportive organisational climates are vital for achieving person-centred care, in which partnerships between clinicians and patients become the established norm. Strategies may include:

• Engaging leadership and the governing body to act as champions for partnerships between clinicians and patients
• Providing enough resources to support clinicians to partner with patients in their care
• Providing education and training to equip clinicians to partner with patients in their care; further information on education and training for clinicians is provided in Action 2.07.¹

Encourage communication and knowledge exchange between clinicians and patients

Patients can be partners in their own care in many ways, including shared decision making, self-management of their condition and personalised care planning. For these partnerships to be meaningful, both the clinician and the patient must feel trusted and respected. Good communication is vital to foster this trust and respect, and drive clinician and patient partnerships.¹

Review the current admissions process to see what information is provided to patients and how that information is given. Identify any communication barriers and areas for improvement, and implement solutions to overcome these. Consider engaging consumers in this review process by holding informal discussions with patients in waiting rooms, or discussing the admission process during a consumer advisory group or focus group.

Use technology such as telehealth, and mobile and tablet apps to interact and share information with patients before, during and after their care. This can be an important strategy for facilitating clinician and patient partnerships across long distances. Develop a policy and procedure to support active engagement of patients during bedside rounding and clinical handovers.

Other strategies to encourage communication and knowledge exchange between clinicians and patients include the following:

• Provide consumers with access to information and resources in a format that meets their needs; this may include
  • general information about their health, condition and healthcare arrangements
  • information and tools about how they can be involved in their own care
  • information that has been developed specifically for them
• Provide patients with timely and open access to their healthcare record, test results and other clinical information relevant to their care
• Encourage clinicians to create an environment in which patients feel confident asking questions, and in which clinicians respond positively to patient needs; this may involve speaking with patients in a neutral environment, away from the clinical setting
• Support patients to take part in shared decision making with decision support tools, such as information sheets, pamphlets and videos that provide structured information about their health options
• Implement self-management of certain aspects of care, such as medicine use, to encourage engagement.^2-5

The Agency for Healthcare Research and Quality provides practical advice for improving clinician and patient communication, including tools to educate consumers on how to be involved in their care.

The SA Health Guide for Engaging with Consumers and the Community provides a tool to help clinicians encourage questions from their patients.

The Commission and Healthdirect Australia developed Question Builder, a free web-based tool to help consumers prepare for a visit to the doctor. In addition, the Commission’s Top Tips for Safe Health Care can help consumers, families, carers and other support people get the most out of their health care.

Develop policies and procedures to guide care planning in partnership with patients

Involve patients in the development of any current and future care planning, such as:

• Inpatient treatment and recovery planning
• Treatment and preventive health strategies for ongoing care outside the health service organisation
• Advance care planning (see Action 5.09).

Strategies for involving patients in care planning may include systematically discussing patient preferences for care during admission consultations, and at regular times during their care. This may be facilitated by including patients in bedside rounding and clinical handovers.⁵

Develop meaningful measures to monitor success

Monitoring and measuring the success of clinician and patient care partnerships is important for ensuring that systems are relevant and useful to consumers and the organisation.^{1, 5}

Strategies for monitoring and measuring the success of the systems may include:

• Collecting informal feedback from patients in waiting rooms and during rounds
• Surveying patients to self-report on their experience and satisfaction with the level of engagement they had in their care.

Use the outcomes of these evaluations to set realistic goals for improving partnerships between clinicians and patients.

Tools and resources are listed in the Resources section of this standard.