Ontario's Patient Engagement Framework

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Goals

This framework is designed to support your efforts to engage with patients and caregivers, and to develop your own patient engagement strategy. A comprehensive patient engagement strategy should aim to:

• Achieve a strategic goal – a strong culture of patient, caregiver and public engagement to support high-quality health care
• Embed the six guiding principles for meaningful engagement in all activities
• Build and connect engagement activities within, and across, the three domains
• Employ a range of engagement approaches from one end of the spectrum, to the other
• Actively build on and feed back into the four enablers of engagement.

The framework also highlights the spectrum of engagement approaches – from sharing, to consulting, to deliberating, to collaborating – and recognizes that these approaches should be customized depending on the engagement goals and setting, and that they often happen simultaneously.

And lastly, the Framework highlights the enablers that make high-quality engagement possible - a dedication to continuous quality improvement; the provision of easy-to-understand information; a commitment to engaging all, including those from under-served populations; and rigorous research and evaluation to constantly learn from our efforts.

Ontario’s Patient Engagement Framework is designed to inspire action towards the ultimate goal – a strong culture of engagement that drives continuously towards better care and better health for Ontarians. With patients and caregivers as partners, there is no limit to the quality of care that Ontario can achieve.

Guiding Principles

These six principles define a strong culture of engagement between patients, their caregivers and health professionals.

Each principle and the statement accompanying it are not meant to be comprehensive but are meant to spark discussion on the commitments necessary to bring about effective engagement. Consider what each of these principles means and how you may be able to bring them to life in your patient engagement work. They will help to ensure engagement activities are meaningful to everyone involved.

1. Partnership
   Meaningful patient engagement requires authentic, timely and mutually beneficial relationships forged between patients, their family members, other informal caregivers, health professionals and the organizations they work with.
   
   
2. Learning
   All participants in patient engagement should expect to learn – about each other’s perspectives and experiences, about facts about the issue at hand, and about how things may improve and be better.
   
   
3. Empowerment
   Patients and their caregivers need to feel empowered to openly express their needs, perspectives and concerns without fear of reprisal, and to make informed decisions with confidence.
   
   
4. Transparency
   Transparency means that health care professionals and organizations are honest about their ap-prehensions, resource limitations, and knowledge gaps when it comes to engaging with patients and caregivers.
   
   
5. Responsiveness
   Being responsive means that health care professionals and organizations act upon the voices of patients, their caregivers and the public in ways that demonstrate the positive impact of this input.
   
   
6. Respect
   Health care professionals and organizations demonstrate respect for their patient and caregiver partners by actively showing signs of appreciation for their time, ideas, lived experiences, various worldviews and cultural locations.

Approaches

From sharing great plain language information or resources, to consulting patients staying in hospital on family visitation policy, to co-designing a program – all approaches are beneficial as long as they are done purposefully and in line with best practices.

For these reasons, and consistent with other engagement frameworks. Our Patient Engagement Framework outlines different approaches to engagement along a spectrum. These are:

1. Share
   This includes the ways health organizations provide information that is easy for patients and their caregivers to get, understand and act upon, to support personal care decisions, as well to support engagement about a program, service, policy or decision.
   
   
2. Consult
   This includes the ways health professionals, organizations and system planners get feedback from patients and their caregivers on a health issue, policy, or decision that needs to be made.
   
   
3. Deliberate
   This includes the ways patients and their caregivers are engaged to discuss a health issue, policy, or decision, and begin to explore solutions with health care professionals.
   
   
4. Collaborate
   This includes patients and their caregivers, health professionals, planners, and organizations finding and applying solutions together to a health issue, policy, or decision.

There is no “one size fits all” approach to ensure patient engagement is done in meaningful and integrated ways. The same approach may look and feel different depending on the health sector, setting, and region, and may produce varying results. The key to integrated and successful patient engagement is matching the right approach, to the right situation, at the right time – and often using more than one approach to achieve the intended goal.

Enablers

This Patient Engagement Framework builds on this research and lists four enablers that specifically support patient engagement to improve health care quality:

1. A culture of continuous quality improvement
   Meaningful patient engagement requires an ongoing commitment from health organizations, and the staff who lead them, to continuously improve – and to use the experiences, perspectives and needs of patients and their caregivers to inform what needs improving.
   
   
2. Access to easy-to-understand health information
   Patient engagement requires health professionals, organizations, and the whole health system to offer patients meaningful opportunities to learn about their health care, and broader health policy and strategy, through access to patient-friendly health information.
   
   
3. Commitment to health equity and cultural competence
   Engaging patients and caregivers for health equity means health care professionals, planners, and organizations have a responsibility to engage with – and respond to – the unique needs of all patients, including those from social groups that have long been disadvantaged by the health system.
   
   
4. Rigorous research and evaluation
   Evaluating the process and outputs of patient engagement activities helps to demonstrate its value and build a case for engaging patients and caregivers in new ways.

All these enablers support meaningful patient engagement and health.

*This was adapted from Ontario's Patient Engagement Framework. Access a copy on the Legislative Library Catalogue.