Why should providers engage patients in improvement work? Marilu Bintz, MD, MBA, FACS; Vice President of Gundersen Health System in La Crosse, Wisconsin Number one, it’s a much more efficient way of doing things. If you have the patients involved from the start, you don’t get the patient perspective retrospectively, so you don’t create something and then have the patients come in and go, “you know you did this all wrong, don’t you?” Get them in at the beginning, and that way, you end up with an end product that everybody is engaged in. We talk a lot about patient activation. We want activated patients. Get them involved in decision making. Get them involved in how the organization is going to improve and get better. Second, it has opened the door. It has given us the reputation of being curious and receptive to what the community has to say. We still go out in the community and say, “What do you think about this? What do you think about that?” But very frequently, it is the patients approaching us saying “Hey, listen, last year I was on that patient advisory council, but I just had a couple more thoughts.” They just keep giving and giving and giving so it’s the fire that keeps feeding itself over and over again. It has made us a much more receptive organization. How did Gundersen get started? We approached patient participation from the patient safety perspective. So what we started out doing was we went out and actively sought out patients we had harmed, and we said, “We want you involved in getting it to be better and making our system, our delivery, making it all better, so that what happened to you doesn’t happen to anyone else.” We began to assemble groups of patients, and we talked about everything. We talked about direct patient care, but we also talked about the billing process. When we designed our new hospital, we brought them in to say, “What do you want to see in a new hospital? What makes you comfortable in this environment? What would create a healing environment from your perspective?” Now we have matured to the point where we have about 150 patient advisors in the organization, and in our current efforts, we are spreading the patient advisory council into our regional clinics and regional hospitals. Geographically, we’re spreading those efforts into our entire service area. That was our journey. The first part was a little slow because we were among the first, but since then, it has really grown and matured very rapidly.