A Narrative Review of Patient and Family Engagement: The "Foundation" of the Medical "Home"
- PMID: 27111748
- PMCID: PMC4907812
- DOI: 10.1097/MLR.0000000000000548
A Narrative Review of Patient and Family Engagement: The "Foundation" of the Medical "Home"
Abstract
Background: Patient and family engagement (PFE) is vital to the spirit of the medical home. This article reflects the efforts of an expert consensus panel, the Patient and Family Engagement Workgroup, as part of the Society of General Internal Medicine's 2013 Research Conference.
Objective: To review extant literature on PFE in pediatric and adult medicine and quality improvement, highlight emerging best practices and models, suggest questions for future research, and provide references to tools and resources to facilitate implementation of PFE strategies.
Methods: We conducted a narrative review of relevant articles published from 2000 to 2015. Additional information was retrieved from personal contact with experts and recommended sources from workgroup members.
Results: Despite the theoretical importance of PFE and policy recommendations that PFE occurs at all levels across the health care system, evidence of effectiveness is limited, particularly for quality improvement. There is some evidence that PFE is effective, mostly related to engagement in the care of individual patients, but the evidence is mixed and few studies have assessed the effect of PFE on health outcomes. Measurement issues and the lack of a single comprehensive conceptual model pose challenges to progress in this field. Recommendations for future research and a list of practical tools and resources to facilitate PFE are provided.
Conclusions: Although PFE appeals to patients, families, providers, and policy-makers, research is needed to assess outcomes beyond satisfaction, address implementation barriers, and support engagement in practice redesign and quality improvement. Partnering with patients and families has great potential to support high-quality health care and optimize outcomes.
Conflict of interest statement
References
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- American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. [Accessed January 23, 2016];Joint Principles of the Patient-Centered Medical Home. 2007 Feb; Available at: http://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiati....
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- Institute for Family-Centered Care web site. [Accessed January 23, 2016];Frequently asked questions. 2010 Dec 29; Available at: http://www.familycenteredcare.org/faq.html.
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- Carman K, Dardess P, Maurer M, et al. Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs. 2013;32(2):223–231. - PubMed
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- American Hospital Association. Engaging health care users: A framework for healthy individuals and communities. Chicago, IL: American Hospital Association; Jan, 2013. 2012 Committee on Research, Benjamin K. Chu and John G. O’Brien, co-chairs.
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