What first step would you suggest for an organization that wants to get better at integrating patients in design work?

Barbara Balik, RN; IHI Senior Faculty, Common Fire Healthcare Consulting

How do I engage patients? I want to do it, and people tend to make it harder than it has to be. The first step is ask one now. Today, if you are in a health care setting, you are within 50 feet of a patient or a family member. All you have to do is ask one now. You might have a question about an improvement in our program. What happens if you go to a waiting room or a patient room, and of course, you have to be mindful of what other stresses are there for the patient and family, but asking, “We’re thinking about this change. What would make a difference to you?” When we’re thinking about helping patients who are going to have surgery today, “What’s really important to you?”

I know a great primary care physician who was wonderful at this. He’d be between patients, and, you know, primary care physicians have nanoseconds between patients. He’d be working on a new education tool he’d want to use with patients or new information he’d send home with them. He’d dash out to the waiting room, find a patient who wasn’t even his own, and say hi. He’d introduce himself. “I have a quick question, would you mind if I asked you this question?” He would get three or four bits of information in a morning, and that’s where you can start.

There’s lots of tools that IHI has online that you can get a link to that can help you determine how you formally start this, how you identify patients. What I usually suggest is, don’t jump to getting to a Patient Family Advisory Council. Those are wonderful, but that can take you a long time and takes a fair amount of thoughtful work to get it done. But today you can start identifying patients who can help you redesign this program or make this improvement or understand what’s important to them.

In an acute care setting, an example I think of is whiteboards. People use lots of whiteboards. Most of them are wasted geography because they’re not used well. This one organization was bound and determined. They were going to redesign these in partnership with patients, so they would ask a patient in their room. One of the team members took a mockup of the board, a whiteboard they were thinking about after they’d gotten some patient information, and went to their volunteer office and parked themselves there for about two hours. Most of the volunteers in acute care settings have been patients or know patients or are friends of patients. They got tons of advice. Another colleague wanted to know what community members thought about some of the health system’s offerings about improving your health and taking care of your health for elders. They went to senior citizen community centers where there are very active seniors and got lots of suggestions and advice and got volunteers to help them. That took like an hour and a half, so we’re not talking about, you have to map out a month’s plan. You can get it done this afternoon. So I encourage people to ask one now.