Transcript Document
Whose Health Service is it Anyway? Leading Management and Organisation Development for the Health Services Public and Patient Partnership in Healthcare: Outline of Discussion Paper Professor Hannah McGee Health Services Research Centre Department of Psychology Royal College of Surgeons in Ireland Partnership: what is it? •Promoting patient participation in own care •Enabling patients to become informed about treatment & to make informed choices •Involving patients & carers in improving service quality •Involving the public as citizens in health service decision-making processes Partnership: why? •Crisis intervention •Reforms/restructuring •Safety & complaints systems •Quality in healthcare movement •Increased voice of patients & advocates Partnership in Ireland NATIONAL HEALTH STRATEGY (2001) •Goal No. 3: responsive & appropriate care delivery •Objective 1: The patient is at the centre in the delivery of care •Participation: one-to-one / care management / community involvement Principles of Partnership I •Rights-based approach •Commitment to building trust •Flexible & accessible communication process •Motivation & commitment to partnership •Flexibility & willingness to adapt •Ethos of fairness & accountability Principles of Partnership II •Mutual co-operation & support •Concern for process as well as outcome •Commitment to delegate power equally •Commitment to embedding partnership within & across health system structures •Commitment to financial support Evaluation framework for participation LEVEL Individual Group Consumerist Model Democratic Model •Dissemination of information •Complaints procedures •Consumer surveys •Involving patients in own care •Consumerpurchaser schemes •Focus groups •Active ‘work’ groups •Patient participation groups •Board memb’ship •Citizen’s juries •Supporting advocacy groups •Stakeholder meetings Factors enabling/mitigating against participation • ENABLERS • Intrinsic respect • Increased adherence • Increased health responsibility • Increased staff satisfaction • Health Strategy (2002) • BARRIERS • Paternalism • Fear of loss of control • Inequity • Time/other pressures • Lack of staff support Evaluation of partnership: key questions WHY?………aims, clarity of purpose HOW? …….right approach, clear roles, involvement in planning, use of feedback, timescales WHAT?……techniques, expectations met, appropriate information & views sought WHO?……..representatives, support given to participation Participation: the three ‘Ps’ •Purpose (what to achieve?) •Process (how to do it?) •Personal integrity (‘keeping your word’) Information needs for partnership • • • • • • • • Strategies for participation How to be effective as participant Making links with participants Integrating feedback into QI Role of consumer councils Why public input is important Patient satisfaction surveys Working with particularly excluded groups Partnership Paper: key points • Emphasis on process as much as outcome • Role of quality in healthcare movements • Dedicated structures (legislative, administrative & educational) & coordinating centres • Explicitly identified partners • Staff as partners Partnership? • Change is inevitable…… Partnership? • Change is inevitable…… …..….except from slot machines……