By now you have a list of patients from whom to gain insight about your mission and consider as patient partner candidates. Each conversation practice members have with PP candidates must be intentional, thoughtful and deliver shared values on partnering. Step three is about keeping everyone on the same page and on track as you make first contact with patient partner candidates.

Tools for Step Three

The project management and communication tools of Step 3 will:

• keep PP engagement thoughtful yet efficient

• establish consistent positive and appreciative messaging

• keep everyone informed of progress and allow time for changes

Be sure to update all quality improvement team members as changes are made to the materials that will be patient facing such as: Scripts and Messaging, Welcome Package or Orientation activities. This emphasizes the importance of the process of engagement, not just the goals. Until everyone in the practice believes in the value of patient partners, the PP champion will be responsible for reminding them of the importance of the PP’s presence and influence.

Print or download each tool you wish to use, edit and share.

Tools for Step Three:

• Checklist for Step Three

• PP Engagement Activities

• Patient Centered Rules of Engagement
  

For Enlisting Practice Members to Assist:

• Request Assistance with PP Engagement (email and worksheet)

• Instruct practice members in making first contact (script)

• Instruct practice members in holding 1-1 conversations (script)

• Checklist for Holding 1-1 conversations (Checklist)

• Capture What Is Learned (instructional message)

• Document PP Feedback (a form)
  

To Support PP Engagement Activities:

• Teamwork and Patient Partner Influence

• Quality Improvement Initiative Goals

• The 5Rs of Patient Partnering

• Making First Contact (formal letter)

• Inviting Your Patient Partners to Join the Team

Conducting Needs Assessments

After meeting with all patient partner candidates, you may find that many are eager to help, or you may discover you need more time and more conversations with candidates to convince them that your team is serious about allowing their insight and expertise to influence their efforts to improve the practice. The good news is that you’ve taken the first step by identifying potential partners. Conducting needs assessments during Step two allowed members of the practice team to shape the makeup and functionality of the team. Now it is time to conduct needs assessments for your potential new partners and allow them to influence the shape and functionality of the team.

The decision to join your team must be made thoughtfully by both the patient partner candidate and each practice team member. Conduct a series of brief needs assessments as you make contact with patient partner candidates and keep track of the resources you will need to shape your team.

Communication: Staying on the Same Trail and Having Fun

Any successful journey should be fun as well as adventurous! Changing the way things are done in your clinic can be filled with appreciation and joy for what has worked well and been successful. Because change is difficult, it is important for those who will be impacted by those changes to celebrate the work that has been done and enjoy a process of building on success. It takes leadership on everyone’s part to set a tone of enthusiasm for the work that must be done. Using an inclusive tone and making sure everyone stays on the same trail (or mission), will prevent the loss of team members along the way. Stopping occasionally to “take in the view”, share common humanity, a healthy sense of humor and celebrate accomplishments, (no matter how small), will keep the quality improvement and partnering experience positive. Avoid the “tyranny of the urgent” at all costs or you may forget what matters most.

Project management and facilitation tools will help you share progress and keep track of engagement and team activities. The tools provided can be revised and shared with all members of the QI team before welcoming your new team members. Allowing the whole practice to follow along, celebrate and add their own contributions to build a successful quality improvement community partnership allows everyone to take ownership, have fun along the way and send the message to both practice members and patients that the work of improving care together with patients is happening and will be enriching for everyone.

Communication: Speaking the Same Language

Patient Partner engagement activities will be the time on your journey for emphasizing the message that the patient is central to the design and the outcomes of the initiative the healthcare quality improvement team has set out to accomplish. The language used must invite: Deeper understanding and empathy about what matters most to patients and families. Language must encourage everyone’s full collaboration and inspire commitment to each other, innovation, and patient centered healthcare.

Language is a tool for transformation

Discovering a shared language that meets everyone's needs takes time, practice, apologies, and forgiveness. There is no time like the PP journey to begin setting a tone of appreciation for transforming language to meet the needs of your team.

Eloquence grows when a person has the chance to share, feel genuinely heard, acknowledged, and appreciated for their presence, effort and contribution to helping improve systems. Confidence grows when a person’s influence makes a positive difference. All team members may need time to practice speaking up. However, during PP engagement, the goal is to allow the patient’s voice to be heard, acknowledged, and appreciated as part of system change. The patient is invited to represent a brand-new role: that of an expert with lived experience managing their health while navigating challenging and often failing systems. Practice members must take on a new role too- that of a learner and a partner rather than the provider and the decision maker. Partners who work together to share decision making, shift power dynamics and bridge communication gaps build long lasting reciprocal relationships.

Sometimes the behavior invites the opposite of what is needed.

Stigma and disparities caused by disease and system inequities can mute or worse, silence a person’s voice and erode their confidence. Fast paced, busy medical schedules and a shortage of resources change the brains and behaviors of the people working within those systems and often invite the opposite of what is needed when managing multiple chronic health conditions. By being offered a chance to participate in innovating change and be heard about what matters to them, the patient voice is amplified and can affect positive and lasting change. Language and behavior that is inviting, curious, inclusive that supports a culture of humble inquiry can bring patients back to the center of the team. During PP engagement, your practice members must offer patients the time and space necessary to honestly speak up and bring their insight, experiences and wisdom to the table where improvements are being initiated.

It may come as a pleasant surprise to patients if their expert medical providers suddenly turn to them asking for their help!

Some patients may find the opportunity you are presenting a breath of fresh air and will be forthcoming about what matters most to them when managing their health conditions. Some may be succinct and eloquent when sharing their experiential wisdom. Others, whose presence and voice is equally as valuable to the process, may be hesitant and uncertain about what they have to offer and may even fear repercussions of judgement, shame or blame when sharing about their healthcare experiences. The patient insight and perspective may take some coaxing to remove these barriers, whether perceived or real. Although perceived, the fear of being too long-winded, wrong, selfish, considered ignorant, or too emotional takes its toll. It takes great courage to speak up when you haven’t been accustomed to being asked your point of view. But it is never too late to begin building capacity for inclusion and equity in healthcare system transformation.

Practice members may feel reluctance for prying into a patient's lived experience. It may be uncomfortable for medical providers to ask patients to share about system failures or even human failures during medical experiences. It may be difficult for medical professionals to face feelings of inadequacy. Using language that is appreciative of the patients’ wisdom and lessons learned from their experiences can help reframe and remove these barriers.

The PP Liaison can set an appreciative tone by modeling and helping everyone feel prepared for meaningful conversations that point towards possibilities and collaboration. Engaging successfully with people who hold the greatest stake in the success of the mission will be sure to get your team headed in the right direction. By preparing all practice members to successfully partner with patients, your leadership sets expectations for building strong trusting reciprocal relationships within your community.

Appreciative and person-centered language is transformative. It allows space for everyone to feel comfortable and inspired to share and learn new things while opening the door for everyone to experience a new vision.

Tools for Speaking the Same Language

Suggested scripts, messaging and talking points, have been included in the Step 3 tools to correspond with each PP engagement activity. Use them to guide thoughtful and consistent communication and to maintain strong reciprocal relationships. Improve on the tools by editing them with your specific details and unique activities your initiative will include. Use language that matches and enhances the personal strengths and skills of your team and community members. Remind practice members the tools are jumping off places to supplement their own successful engagement skills. Remind practice members that their own expertise is highly valued and will bring far reaching rewards.

Thank you for taking the time to consider how important communication and language is to your Patient Partner journey.

Enlisting Practice Members to Assist with PP Engagement

Your practice members already have a variety of skills for building reciprocal relationships with patients who come from diverse populations, so you should have no problem getting people to assist. Invite practice members to assist who understand how patient partnering supports the Initiative goals. Invite practice members to help who demonstrate strong patient/provider relationships. Invite practice members to help who support:

• Open, honest discussions.

• Cultural humility for chronic illness, behavioral and social determinants.

• A commitment to learning from patients.

• Appreciation for hearing diverse forms of communication.

• Shared decision making and collaborating with patients

Invite practice members to assist who also can:

❏ Support Patient Partner Inclusion on the team throughout the Initiative

❏ Practice patient-centered language

❏ Dedicate time to prepare for and carry out thoughtful patient partner engagement

❏ Demonstrate compassion for oneself and others

❏ Connect with PPs on a human level

❏ Build collegial relationships with PPs

Patient Partner Step 3 Engagement activities

The following is a list of the activities and the skills which may help engage the patient partner insight and feedback for your initiative goals and help you locate at least 2 patients who might be willing to get more involved. A copy of this document as a separate page can be found here.

Scheduling First Contact

Choose members of your practice who are responsible for answering the phone and have access to practice member’s schedules. This practice member will also need to understand the importance of a consistent message of appreciation for patient partnering goals and will need access to the tools you will use for keeping track of engagement activities to facilitate prompt and successful interfacing between PPs and practice members during the PP engagement process.

Making Your Selection and Inviting the PP to join the team

After engaging with patients as partners on the Initiative, you will need to come to an agreement about who will join your team in planning, designing, and implementing the initiative’s goals as a new PP member of the team. Meet with all practice members conducting 1-1 conversations to make the final decision and assign the task of making the formal invitation. If the patient’s own provider is assigned to make the invitation, the provider should assure them that their contributions and opinions will be considered valuable and always appreciated as an essential element of the team’s success. This is essential to ensuring sustainable partnerships with members of your community.

Looking Ahead at Step Four:

Welcoming and Orienting the Patient Partner to the Initiative Team

You will prepare for this activity on Step Four once you are confident you have found two PPs to join the team. Don’t do this alone. It is advisable to encourage other practice members to assist you with this activity who might also benefit from gaining more knowledge about the patient perspective, lived experience and their relationships to clinical operations and practice members. Including other practice members when welcoming and orienting new PPs to the team can serve to build strong team relationships and support.

Pause for a moment to breathe, take in the view of what you have accomplished and reflect on your own strengths….

Compassion is not a relationship between the healer and the wounded. It’s a relationship between equals. Compassion becomes real when we recognize our shared humanity.

Pema Chodron

The secret of change is to focus all of your energy not on fighting the old, but on building the new

Socrates

Special thanks

Thank you for taking the time to consider how important communication is before beginning the tasks of PP Engagement. By preparing so thoughtfully, you will have stepped over some very large hurdles on the journey towards successful patient partnering.

Next Steps: Print or Download the Checklist for Step Three to carry out the tasks for preparing practice members to assist you, so that PP Engagement activities can begin asap!

Nothing can dim the light that shines from within

Maya Angelou

For more resources on patient and family engagement in system transformation to support Step 3 please visit:

https://sites.google.com/view/partneringguide/partnering-guide-for-research/additonal-resources

Roadmap-Patient-Family-Engagement.pdf (air.org)

If you are ready to move on to Step 4 Click here