How Patient Partners Influence Quality Improvement Efforts.

Background: There is growing acknowledgement that patients are key stakeholders in improving quality of medical care, yet a key barrier to integrating patients into quality improvement teams (QITs) as patient partners is the lack of evidence of their impact. This mixed-method study was conducted to identify the ways patient partners influence QITs and to document the extent of patient partners' impact.

Methods: Focus groups and in-depth interviews were conducted with 17 patient partners and 11 staff at WellSpan Health and Aligning Forces for Quality-South Central Pennsylvania to identify the specific mechanisms through which patients influenced QIT efforts. Online surveys of 47 patient partners and 56 QIT leaders were conducted in summer 2016 to test the ways in which patient partners affected quality improvement (QI) and gauge respondents' perceptions of the impact of patient partners' contributions.

Results: Patient partners influenced QI through three key mechanisms: symbolism, providing feedback (on written material for patients and new policies), and making suggestions (on office communication, educational materials, physical space, and clinical care processes). Almost three quarters of the patient partners believed they had a moderate to very large impact on their QIT's QI efforts. Eight of the 10 QIT leaders reported that patient partners improved patient-centeredness of QI a "moderate amount" to a "great deal" through one of the three key mechanisms.

Conclusion: Integrating patient partners into ambulatory care QITs was a largely positive experience for patient partners, QIT leaders, and administrators. The changes that patient partners prompted were meaningful and likely improved patients' experience with care.