Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?

Abstract Background Around the world, many healthcare organizations engage patients as a quality improvement strategy. In Canada, the University of Montreal developed a model which consists in partnering with patient advisors, providers, and managers in quality improvement. This model was introduced through its Partners in Care Programs experimented in several quality improvement teams in Quebec, Canada. Partnering with patients in quality improvement brings about new challenges for healthcare managers. Although this model is recent, little is known about how managers contribute to implementing and sustaining it using key practices. Methods In-depth multi-level case studies were conducted within two healthcare organizations which have implemented a Partners in Care Program in quality improvement. The longitudinal design of this research enabled us to monitor the implementation of patient partnership initiatives from 2015 to 2017. In total, 38 interviews were carried out with managers of different levels (top-level, mid-level, and front-line) involved in the implementation of Partners in Care Program. Additionally, seven focus groups were conducted with patients and providers. Results Our findings show that healthcare managers are engaged in four main types of practices: 1-designing the patient partnership approach for it to make sense to the entire organization; 2-structuring patient partnership to support its implementation and sustainability; 3-managing patient advisor integration in quality improvement to avoid tokenistic participation; 4-evaluating patient advisor integration to support continuous improvement. Designing and structuring patient partnership are based on traditional management practices usually used to implement quality improvement initiatives in healthcare organizations, whereas managing and evaluating patient advisor’ integration require new daily practices from managers. Our results revealed that managers of all levels, from top to front-line, are concerned with the implementation of patient partnership in quality improvement. Conclusion This research adds empirical support to the lack of evidence on daily managerial practices used for implementing patient partnership initiatives in quality improvement and contributes to guiding healthcare organizations and managers when integrating such approaches.

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