When we talk about patient and family engagement, it’s tough not to consider the barriers. Problems with health literacy, for example, may hinder patients’ understanding of diagnoses, medication regimens, and care plans. Fear of being considered “difficult” may prevent patients from speaking up. Providers may not have to tools, training, or time to actively engage with patients.
Every patient is unique, and health care professionals intent on achieving engagement at the level of clinical care have to think about all of these barriers and more. It is not surprising that attempts to improve patient and family engagement often fall short or are unsustainable.
Today in Orlando at the 16th Annual NPSF Patient Safety Congress, we will celebrate some of those who are overcoming the barriers, as Nasia Safdar, MD, University of Wisconsin Hospital, and the OpenNotes Collaborative are announced as recipients of the first John Q. Sherman Award for Excellence in Patient Engagement.
Conferred by Standard Register Healthcare in partnership with the NPSF Lucian Leape Institute, the Sherman Award was created to recognize individual and organizational efforts that bring measurable results, are sustainable, offer the potential to be replicated by others, are collaborative, and advance patient engagement.
Dr. Safdar was chosen to receive the individual award for her outstanding work in reducing healthcare-associated infections. As hospital epidemiologist, she has worked with patients through the organization’s Patient and Family Advisory Council to develop patient education materials, a pre-surgical checklist, and collaborative procedures for increasing hand hygiene. Moreover, she has spread the knowledge and results through scholarly papers showing the need for better involvement of patients in infection control.
Much of the hospital’s success in reducing HAIs has been attributed to Dr. Safdar’s efforts. Among those results:
- Catheter-associated urinary tract infections reduced by 47%
- C. difficile infections reduced from 16 to 12 infections per 10,000 patient days over a one-year period.
- Hand hygiene rates among health care workers increased from 50% to 90% in one year
- Reduced surgical site infections.
In nominating Dr. Safdar for the Sherman Award, Linda Stevens, DNP, RN-BC, CPHQ, CSPHP, director, Nursing Quality and Safety, University of Wisconsin Hospital and Clinics, wrote, “Infection control is by nature a collaborative process. Dr. Safdar…is driving systems change in this area by providing inspiration to patients and providers about what a patient-centered model for infection prevention can achieve.”
The OpenNotes Collaborative was chosen to receive the organizational award for its innovative program that brings transparency in health care to a new standard. Started in 2010 as a year-long trial involving 100 primary care doctors and 60,000 patients at three different health systems, OpenNotes is now being utilized by a number of institutions—and by more than 3 million patients.
The idea itself is so simple: Make the physician’s notes available to the patient. The initiative not only brings true partnership to the doctor-patient relationship, it also enhances safety, as patients point out erroneous details, more easily remember to follow up on important information, and have the opportunity to go back and review discussions and information, rather than frantically trying to grasp it all in a 15-minute office visit.
At the end of the initial trial, both physicians and patients reported being happier and more satisfied. The initial pilot demonstration showed that 82% of patients had used the notes—a pretty high level of engagement by any standard—and 99% of the patients involved wanted the program to continue. Moreover, when doctors had the opportunity to leave the trial (and seal their notes again), none chose to do so. Patients reported taking better care of themselves, understanding their conditions better, feeling more prepared for visits, and feeling more in control of their care.
The very deserving recipients of the Sherman Award are amazing examples of real, sustainable work that can better engage patients in their care, improve quality and safety, and enhance doctor-patient relationships. The National Patient Safety Foundation and Standard Register Healthcare also thank the 35 others from 23 states who were nominated for this award. There is a lot of great work being done across the country to improve health care quality and safety, as we are seeing this week in Orlando. Congratulations to the John Q. Sherman Award recipients, and to all who are working so hard to overcome barriers to safer care.