Action 2.11

Consumers can make effective and meaningful contributions to health service planning and development through their involvement in organisational governance and decision-making.¹ To enable these contributions, integrate partnering with consumers into the governance systems of the organisation.

Review the diversity of consumers who use the organisation’s services and make up the local community

Consumer partnership and engagement activities should truly reflect the diversity of consumers who use, or may use, the organisation’s services. Gathering information about the type of consumers who use the organisation’s services and comprise the local community can help identify specific consumer groups who should be involved in partnerships with the organisation.

Strategies may include^2-4:

• Undertaking a community profiling project, which involves gathering information about the diversity within the community; its history, social and economic characteristics; the groups and networks within the community; and the social and infrastructure services that exist
• Administering surveys to identify diversity among current patients and carers
• Using demographic data from the Australian Bureau of Statistics, or local, state and territory government sources to understand the background of the organisation’s consumers
• Networking with other organisations or individuals in the community such as culturally and linguistically diverse community groups, community participation managers, Primary Health Networks, Local Hospital Networks, local and state government organisations, and professional associations to share knowledge about community needs.

Review the current level of consumer partnerships

Identify the organisation’s current levels of engagement with consumers. Assess consumer partnership and involvement in the organisation’s:

• Governance
• Strategic and operational planning
• Health service design, redesign and evaluation
• Review of safety and quality performance.

Strategies may include:

• Conducting a self-assessment of the organisation’s engagement with consumers
• Making a list of current committees or groups involved in strategic planning, health service design, and organisational safety and quality performance, and identifying the level of consumer involvement in these groups; interview consumers who currently take part in these committees or groups and find out whether they feel their voice is being heard
• Talking to the workforce involved in strategic planning, health service design, and reviewing organisational safety and quality performance information to find out how they work with consumers
• Reviewing policies or processes to identify whether there is currently a need for consumer involvement in the design, measurement and evaluation of healthcare services.

If consumer partnerships are already embedded within design, measurement and evaluation activities, use tools such as the Partnership Self-Assessment Tool or the Patient Based Care Challenge to assess the extent and effectiveness of those partnerships. Map the existing arrangements against the strategies suggested below to identify other systems or ideas.

If the organisation does not currently partner with consumers in its design, measurement and evaluation activities, establish a framework and associated processes to actively involve consumers.

Support consumer partnerships in governance and strategic leadership

Strategies to support, promote and improve consumer partnerships in governance and strategic leadership may include:

• Engaging organisational leaders to act as champions for consumer partnerships
• Creating meaningful positions for consumers on formal governance committees, such as boards, advisory groups and community councils^1,5,6
• Creating consumer-only advisory groups that provide direct input to leadership and management structures⁷
• Developing a formal and consistent method for recruiting consumers to be involved in committees⁸
• Implementing a structured support program for consumers involved in governance and strategic leadership roles, which includes orientation and training for consumers to ensure that they feel equipped to provide valuable and meaningful input into discussions and decision-making¹
• Employing a facilitator or coordinator to engage with, support, and build the confidence of, current and potential consumer partners^{1, 9}
• Providing a mentoring service between experienced and new consumer partners¹ – for example, the Consumer Buddy Program at the Walter and Eliza Hall Institute of Medical Research encourages long-term and meaningful engagement of consumers in medical research processes
• Educating the workforce to improve their understanding of the many potential roles for consumer partners in governance and strategic leadership¹
• Creating a leadership position with responsibility for improving the organisation’s commitment to consumer partnership – for example, the ‘chief experience officer’ at the Cleveland Clinic reports directly to the chief executive officer, and provides overall leadership for consumer partnerships within the organisation¹⁰
• Providing reimbursement and/or remuneration to consumers who take part in governance and leadership activities to ensure that consumer partners are not out of pocket, and to reflect the value and importance of their input.^1,11

Support consumer partnerships in safety and quality activities

Strategies to support, promote and improve consumer partnerships in safety and quality activities may include:

• Providing multiple opportunities for consumers to provide feedback on the safety and quality of services; this may include surveys, suggestion boxes and opportunities for formal or informal consultation at multiple times throughout a patient’s care¹
• Engaging consumers in analysing organisational safety and quality performance^1,11
• Engaging consumers in evaluating patient feedback data^1,11
• Involving consumers in planning and implementing safety and quality improvement activities^1,11
• Shaping the attitudes of the workforce so that there is greater acknowledgement, acceptance and understanding of the value of consumer feedback; consumers can provide a unique insight into safety and quality risks, which issues should have priority, and which solutions are acceptable¹
• Regularly informing consumers and the wider community of adverse events or problems relating to care, and the corrective action that has been implemented¹¹
• Involving consumers in developing consumer information about clinical safety issues, such as potential risks and side effects of care.¹¹

Support consumer partnerships in performance and skills management

Strategies to support, promote and improve consumer partnerships in performance and skills management may include:

• Engaging consumers in workforce recruitment, potentially by including consumers on workforce selection panels¹
• Involving consumers in workforce training about consumer participation (see Action 2.6).

Review existing policies and processes for engaging with consumers

Ensure that policies and processes include engaging with a diverse range of consumers who best represent the organisation’s service users and local community. This includes ‘hard-to-reach’ consumer groups, such as Aboriginal and Torres Strait Islander people, or culturally and linguistically diverse communities. Talk to the workforce about how they involve these groups.

Connect with diverse and hard-to-reach consumers

If the organisation does not actively engage with diverse groups of consumers, develop or adapt a policy to engage with these consumers. Several strategies may be needed because different people will respond to different engagement methods.

Strategies for partnering with diverse and hard-to-reach consumers include:

• Engaging with community leaders, groups or liaison officers to determine the most appropriate engagement strategies for particular groups within the community; this will help identify any barriers to participation before approaching them
• Inviting representatives from these groups to join boards or be involved in consumer advisory groups.

More ideas for connecting with diverse and hard-to-reach consumers can be found in the Health Care Providers’ Guide to Engaging Multicultural Communities and Consumers.

Use consumer information respectfully

Ensure that, if feasible, the organisation acts on the information provided by consumers and feeds back information on changes that have occurred as a result of consumer advice.

Ensure that information provided by consumers or carers about their experiences is treated sensitively, that privacy and confidentiality are maintained, and that consumers and carers are supported to share their experiences and stories to the extent that they are comfortable.

Resources to help consider the consumer role include:

• Victorian Quality Council Enabling the Consumer Role in Clinical Governance: A guide for health services¹⁵
• Cancer Australia Consumer Involvement Toolkit.¹⁶

Consumers can make effective and meaningful contributions to health service planning and development through their involvement in organisational governance and decision-making.¹ To support these contributions, integrate partnering with consumers into the governance systems of the organisation.

Interactions of day procedure services with consumers are generally short term. However, many effective strategies are available for engaging consumers in the design, measurement and evaluation of services. If the day procedure service is part of a larger, networked group, see whether the network partners with consumers in its design or evaluation activities. If so, the service may be able to draw on these partnerships for input into local design or evaluation activities.

If the service is not part of a larger network or does not already partner with consumers, use the strategies below to adopt or adapt a framework that encourages consumer input into design and evaluation activities.

Strategies to promote consumer input include:

• Engaging organisational leaders to act as champions for consumer partnerships
• Incorporating consumer stories into the organisation’s governance and leadership meetings to keep consumers’ needs and perspectives in mind; this may involve starting each meeting by reading a story of a consumer’s recent experience with the service or by inviting a consumer to speak at meetings
• Inviting consumers to participate in the governance group or strategic planning team; services can identify interested consumers through pre- or post-procedure surveys, or through informal conversations during their care
• Building relationships with local health consumer organisations; services may be able to draw on these relationships to provide input into strategic planning, safety and quality, and performance management activities
• Providing opportunities for consumers to provide feedback on the governance and leadership of the service, and the safety and performance of the services provided – for example, surveys, suggestion boxes, and opportunities for formal or informal consultation at multiple times throughout a patient’s care, such as during follow-up phone calls¹
• Shaping the attitudes of the workforce so that there is greater acknowledgement, acceptance and understanding of the value of consumer feedback; consumers can provide a unique insight into safety and quality risks, which issues should have priority, and which solutions are acceptable.¹

It is also important to ensure that consumer partnership and engagement activities truly reflect the diversity of consumers who use, or may use, the service.

Day procedure services may provide care to people from different communities, not just those from the local area. Services should gather information about the diversity of consumers who use their service to identify specific consumer groups who should be involved in partnerships, and develop or improve current communication mechanisms.¹²

A first step in this process is to routinely collect patient data through pre-admission screening or by administering surveys to help identify diversity among current patients.

For guidance on undertaking surveys, see the Participation Toolkit, including the ‘Surveys and questionnaires’ section.

In addition, the following resources can be used to guide partnerships with consumers:

• Health Issues Centre Getting Started toolkit
• Health Care Providers’ Guide to Engaging Multicultural Communities and Consumers
• Cancer Australia Consumer Involvement Toolkit.

Examples of evidence

Select only examples currently in use:

• Policy documents that describe the process for involving consumers in partnerships to design, measure and evaluate health care
• Description of the roles and responsibilities of consumers in strategic, operational and service planning partnerships
• Membership of groups tasked with steering design and redesign projects, including consumers who are representative of the patient population
• Committee and meeting records that show consumer involvement in activities relating to healthcare planning, design, measurement and evaluation
• Project plans and reports that include information on consumer involvement in the development of design or redesign projects
• Reports from designers and architects outlining how they have responded to consumer suggestions for improvements
• Feedback from consumers, survey results or evaluation reports on the processes of engagement and support provided to consumers
• Reports that detail consumer participation in activities to design, measure and evaluate health care, such as notes from interviews or focus groups, planning workshops or forums, or meetings with community and consumer organisations
• Committee and meeting records that show that the health service organisation is represented at local network meetings that reflect the diversity of the local consumer population
• Feedback from consumers and consumer representatives on the involvement of consumers in governance, planning, design, measurement and evaluation of health care.

MPSs or small hospitals that are part of a local health network or private hospital group should ensure that consumers from their service are encouraged and supported to take part in established design, measurement and evaluation activities.

Small hospitals that are not part of a local health network or private hospital group should develop mechanisms for actively involving consumers – for example, by:

• Inviting consumers to be part of relevant working groups
• Talking with consumers in waiting rooms or at informal meetings
• Using data about consumer experiences (such as state-based patient experience surveys or local surveys) to help identify key issues and opportunities for improvement
• Meeting with community and consumer organisations to identify key issues and opportunities for improvement
• Holding a joint workshop with members of the workforce and consumers.

Consumer partnership and engagement activities should reflect the diversity of consumers who use, or may use, the organisation’s services.

Identify the organisation’s current levels of engagement with consumers by:

• Conducting a self-assessment of the organisation’s engagement with consumers
• Making a list of current committees or groups involved in strategic planning, health service design, and organisational safety and quality performance, and identifying the level of consumer involvement in these groups; interview consumers who currently take part in these committees or groups and find out whether they feel their voice is being heard
• Talking to the workforce involved in strategic planning, health service design, and reviewing organisational safety and quality performance information to find out how they work with consumers
• Reviewing policies or processes to identify whether there is currently a need for consumer involvement in the design, measurement and evaluation of healthcare services.

If the organisation does not actively engage with diverse groups of consumers, develop or adapt a policy to engage with these consumers. Several strategies may be needed because different people will respond to different engagement methods. Strategies for partnering with diverse and hard-toreach consumers include:

• Engaging with community leaders, groups or liaison officers to determine the most appropriate engagement strategies for particular groups within the community; this will help identify any barriers to participation before approaching them
• Inviting representatives from these groups to join boards or be involved in consumer advisory groups.

Use consumer information respectfully

Ensure that, if feasible, the organisation acts on the information provided by consumers and feeds back information on changes that have occurred as a result of consumer advice.

Ensure that information provided by consumers or carers about their experiences is treated sensitively, that privacy and confidentiality are maintained, and that consumers and carers are supported to share their experiences and stories to the extent that they are comfortable.