Eng Engaging P Patients, F Fam amilies & & Stak - - PowerPoint PPT Presentation

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Eng Engaging P Patients, F Fam amilies & & Stak - - PowerPoint PPT Presentation

Dec 15, 2023 283 likes •776 views

Eng Engaging P Patients, F Fam amilies & & Stak akeholders t to o Impr prove Hos ospi pital Car Care: Exper erienc ences es w with h the i-HO HOPE S Study Luci K. Leykum, MD, MBA, MSc, FACP, SFHM Investigator, South

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Eng Engaging P Patients, F Fam amilies & & Stak akeholders t to

  • Impr

prove Hos

  • spi

pital Car Care: Exper erienc ences es w with h the i-HO HOPE S Study

Luci K. Leykum, MD, MBA, MSc, FACP, SFHM

Investigator, South Texas Veterans Health Care System Center Lead, Elizabeth Dole CoE for Veteran & Caregiver Research Professor, Dell School of Medicine, UT Austin

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SLIDE 2

Road Map

  • Background to I-HOPE
  • Approach & Methods
  • I-HOPE Study Findings
  • Dissemination
  • Reflections on patient

partnerships

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Agenda

  • Background to I-HOPE
  • Approach & Methods
  • I-HOPE Study Findings
  • Dissemination
  • Reflections on patient partnerships
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Backgroun und: d: W Why o

  • ur s

study dy w was n needed eded

  • Hospitalization is a vulnerable time for patients and caregivers
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SLIDE 5

Backgroun und: d: W Why o

  • ur s

study dy w was n needed eded

  • Hospitalization is a vulnerable time for patients and caregivers
  • Gaps in care quality are well documented, and difficult to close
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SLIDE 6

Trends in adverse events

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SLIDE 7

Value based purchasing

  • MS-DRG payments reduced by 2%
  • Hospitals receive payments based on performance

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2214

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SLIDE 8

Backgroun und: d: W Why o

  • ur s

study dy w was n needed eded

Patient and caregiver priorities with regard to improving hospital care were unknown

We believed engagement was central to effectively improving hospital care

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SLIDE 9

Backgroun und: d: W Why o

  • ur s

study dy w was n needed eded

Patient and caregiver priorities with regard to improving hospital care were unknown

We believed engagement was central to effectively improving hospital care

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Aims

To systematically engage patients, caregivers and other stakeholders to create a prioritized list of questions to guide research and improvement efforts for the care of hospitalized patients.

Ou Our A Aim

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Roa

  • ad M

d Map

  • Background to I-HOPE
  • Approach & Methods
  • I-HOPE Study Findings
  • Dissemination
  • Reflections on patient

partnerships

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SLIDE 12

Approach

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SLIDE 13
  • 1. Steering Committee

formation

  • 2. Stakeholder

identification and training

  • 3. Online Survey
  • 4. Refining Survey

Responses

  • 5. In-person

prioritization

Approach

Guided by:

  • PCORI standards for

formulating research questions

  • James Lind Alliance Methods

for Stakeholder Engagement

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PCORI Research Standards

  • Identify gaps in evidence
  • Develop a formal protocol
  • Measure outcomes that people care about
  • Identify / engage patients and stakeholders
  • Use patient reported outcomes
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James Lind Alliance

  • Sets standards for priority setting partnerships
  • Process for identifying & prioritizing questions

Collect potential questions Categorize questions Rank questions Develop prioritized list

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Methods hods: S Steer ering Committee F ee Formation

  • n

Seven Academic Medical Centers

Researcher Patient Partner

Supporting and Dissemination Partner

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Methods: Stakeholder Identification & Training

  • 37 stakeholder organizations identified:
  • Patient & Caregiver Organizations
  • Patient & Family Advisory Councils
  • Medical/Professional Societies
  • Research and Quality Improvement Organizations
  • Stakeholder representative(s) identified
  • Leaders from stakeholder organizations participated in
  • rientation webinars
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SLIDE 19
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Methods: Online Survey

  • Stakeholder organizations surveyed their

leadership and/or members:*

  • Questions they had about hospitalization
  • Suggestions for hospital care improvement
  • Representative sent electronic survey

invitation and link to group’s constituents.

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SLIDE 21
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Road Map

  • Background to I-HOPE
  • Approach & Methods
  • I-HOPE Study Findings
  • Dissemination
  • Reflections on patient

partnerships

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Methods: Refining Survey Responses

  • 499 respondents
  • 117 patients
  • 127 caregivers
  • 267 healthcare providers
  • 63 researchers
  • 10 policy makers
  • 4 industry
  • 4 payors
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SLIDE 24
  • 782 questions/areas of

improvement submitted

  • Categorized into 73 topics/themes
  • 53 health system
  • 20 disease specific

Methods: Refining Survey Responses

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Health System

Care Transitions: Discharges Medications Patient understanding Evidence-based medicine/practice Management practices Communication Post-acute care Patient education Models of Care Patient experience Post-acute care: What do I do? What to expect Post-acute care: Who do I call? Financial / Insurance Matter

Disease Specific

Surgery Dementia Pain management CHF Other Diseases

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SLIDE 26
  • 782 questions/areas of

improvement submitted

  • Categorized into 73 topics/themes
  • 53 health system
  • 20 disease specific
  • 36 commonly submitted questions

identified

Methods: Refining Survey Responses

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SLIDE 27

Methods: In-person prioritization meeting

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SLIDE 28

Methods: In-person prioritization meeting

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SLIDE 29
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6. Can telemedicine technology be used to reduce readmissions or improve transitions of care in hospitalized patients?

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6. Can telemedicine technology be used to reduce readmissions or improve transitions of care in hospitalized patients? 7. Who should the patient call after discharge, if they have questions, concerns, or need to be connected to appropriate resources?

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6. Can telemedicine technology be used to reduce readmissions or improve transitions of care in hospitalized patients? 7. Who should the patient call after discharge, if they have questions, concerns, or need to be connected to appropriate resources? 8. What are the most effective ways for patients and providers to partner in understanding information about diagnosis, steps taken to explore it, treatments undertaken, and what needs to happen after discharge?

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6. Can telemedicine technology be used to reduce readmissions or improve transitions of care in hospitalized patients? 7. Who should the patient call after discharge, if they have questions, concerns, or need to be connected to appropriate resources? 8. What are the most effective ways for patients and providers to partner in understanding information about diagnosis, steps taken to explore it, treatments undertaken, and what needs to happen after discharge? 9. What are patient’s expectations related to the treatment of pain?

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6. Can telemedicine technology be used to reduce readmissions or improve transitions of care in hospitalized patients? 7. Who should the patient call after discharge, if they have questions, concerns, or need to be connected to appropriate resources? 8. What are the most effective ways for patients and providers to partner in understanding information about diagnosis, steps taken to explore it, treatments undertaken, and what needs to happen after discharge? 9. What are patient’s expectations related to the treatment of pain?

  • 10. What are the best interventions to achieve medication optimization

throughout the patient’s care trajectory?

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6. Can telemedicine technology be used to reduce readmissions or improve transitions of care in hospitalized patients? 7. Who should the patient call after discharge, if they have questions, concerns, or need to be connected to appropriate resources? 8. What are the most effective ways for patients and providers to partner in understanding information about diagnosis, steps taken to explore it, treatments undertaken, and what needs to happen after discharge? 9. What are patient’s expectations related to the treatment of pain?

  • 10. What are the best interventions to achieve medication optimization

throughout the patient’s care trajectory?

  • 11. Would providing more clear and accessible information regarding

hospital practices result in improved patient experiences compared to current practices?

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SLIDE 36

Road Map

  • Background to I-HOPE
  • Approach & Methods
  • I-HOPE Study Findings
  • Dissemination
  • Reflections on patient

partnerships

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Dissemination

  • Patients, Families, and Caregivers
  • PFAC Networks
  • PCORI Ambassador
  • Healthcare providers
  • Healthcare systems
  • Clinicians and Researchers
  • Publications and presentations
  • Funding agencies
  • Stakeholder Organizations
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SLIDE 38

Road Map

  • Background to I-HOPE
  • Approach & Methods
  • I-HOPE Study Findings
  • Dissemination
  • Reflections on patient

partnerships

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Patient Partner Experiences

  • Partners involved every step of the project:
  • Bi-weekly Steering Committee calls
  • Survey design
  • Analyses
  • In-person prioritization
  • Dissemination

“True partnership with researchers – Not checking a box”

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Impact of collaboration with patient partners

  • Survey tool development
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Impact of collaboration with patient partners

  • Data analysis and codebook development
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Impact of starting with the patient perspective

  • Relationships, not processes
  • Patient perspective versus patient understanding
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43

Patient Provider

Implications for improving hospital care

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44

Patient Provider Family Consultant Nurse P.T. Nutrition Nurse Nurse Consultant Social work Cross- covering providers Radiologist PCP Pharmacy Learner

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Relationships Processes

46

Resources

Implications for improving hospital care

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I-HOPE PE S Steer eering C ng Committee ee a and S Stud udy T Team

  • Esther Avitia, Luci Leykum, Becky Coker (STVHCS / UTHSCSA)
  • Michelle Archuleta & Marisha Burden (UC Denver)
  • Jim Banta, Margaret Fang & James Harrison (UCSF)
  • Joy Benn, Lali Silva, Jawali Jaranilla (Health East Care System)
  • Julie Hagan & Shaker Eid (John Hopkins University)
  • Melissa Wurst & Mona Mullick (University of Washington in St Louis)
  • Georgiann Ziegler, Vineet Chopra (University of Michigan)
  • Kathlyn Fletcher (Medical College of Wisconsin)
  • Christopher Nyenpan (Society of Hospital Medicine)
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SLIDE 48

https://www.hospitalmedicine.org/clinical-topics/i-HOPE-study