Health affairs
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Patient and family engagement offers a promising pathway toward better-quality health care, more-efficient care, and improved population health. Since definitions of patient engagement and conceptions of how it works vary, we propose a framework. ⋯ We also discuss the factors that influence whether and to what extent engagement occurs. We explore the implications of our multidimensional framework for the development of interventions and policies that support patient and family engagement, and we offer a research agenda to investigate how such engagement leads to improved outcomes.
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For many patients, the time spent meeting with their physician-the clinical encounter-is the most opportune moment for them to become engaged in their own health through the process of shared decision making. In the United States shared decision making is being promoted for its potential to improve the health of populations and individual patients, while also helping control care costs. ⋯ To achieve the promise of shared decision making, more physicians need training in the approach, and more practices need to be reorganized around the principles of patient engagement. Additional research is also needed to identify the interventions that are most effective.
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The practice of patient-centered care remains in its developmental stages-hampered, in part, by limited evidence of its effectiveness. In this article we first review available evidence on patient-centered care, such as the positive effects of engaging patients in quality improvement activities. ⋯ We then discuss the benefits of involving consumers in the design and improvement of products and services outside the health care industry, and we present early lessons on engaging patients to improve ambulatory care in four communities--Humboldt County, California; south central Pennsylvania; Maine; and Oregon--participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality initiative. These lessons, although early, illustrate that actively engaging patients in improving ambulatory care improves provider-patient communication, identifies and avoids potential challenges to new services, and improves provider and patient satisfaction.