小松 康宏
 医療の質・安全学会誌/17 巻 (2022) 1 号


Patient And Family Engagement: A Framework For Understanding The Elements And Developing Interventions And Policies
Kristin L. Carman, Pam Dardess, Maureen Maurer, Shoshanna Sofaer, Karen Adams, Christine Bechtel, and Jennifer Sweeney

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 first present the forms engagement can take, ranging from consultation to partnership. We discuss the levels at which patient engagement can occur across the health care system, from the direct care setting to incorporating patient engagement into organizational design, governance, and policy making. 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.
Patient and family engagement: a survey of US hospital practices
Jeph Herrin, Kathleen G Harris, Kevin Kenward, Stephen Hines, Maulik S Joshi, Dominick L Frosch
Background Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known.
Objective We report on a survey of hospitals in the USA regarding their PFE practices during 2013–2014.
Results The response rate was 42%, with 1457 acute care hospitals completing the survey. We constructed 25 items to summarise the responses regarding key practices, which fell into three broad categories: (1) organisational practices, (2) bedside practices and (3) access to information and shared decision-making. We found a wide range of scores across hospitals. Selected findings include: 86% of hospitals had a policy for unrestricted visitor access in at least some units; 68% encouraged patients/families to participate in shift-change reports; 67% had formal policies for disclosing and apologising for errors; and 38% had a patient and family advisory council. The most commonly reported barrier to increased PFE was ‘competing organisational priorities’.
Summary Our findings indicate that there is a large variation in hospital implementation of PFE practices, with competing organisational priorities being the most commonly identified barrier to adoption.
・本日11/7(月)は、6時起床.午前中は主に"Causal Inference: What If"を訳しておりました.午後から出勤し、回診、夜間診療でした.夜間診療は結構?繁盛してお二人様入院です.帰宅は20時半前.いつものようにネコたちに餌をやってきてから入浴、夕食.録画の『孤独のグルメ』を観ておりました.その後このブログを書いております.今、とても眠い.読みかけの文献を読み終えたかったのですが、明日朝早く起きて(できるか?)読むことにします.これから、歯磨きしてサッサと寝ます.

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