Abstract
Introduction: Researchers have found that shared decision-making with patients goes beyond clinical practice. Patient involvement in healthcare is evolving from being a consultant on an individual level to a partner in decision-making at the policy and governance levels. Most partnership methodologies focus on co-designing care that fits patients' needs and expectations rather than focusing on the initial step of the quality improvement cycle, which is diagnosis.
Objectives: The purpose of this study is to assess the effectiveness of the partnership in the co-diagnosis approach, through the design of a comprehensive audit tool that will be used by patient partners. Patients were empowered to act as quality professionals in the study, marking it as the first comprehensive research methodology applied at a specialty hospital in Lebanon.
Methods: A quasi-experimental study design without concurrent controls with 50 patients recruited as partners in co-diagnoses for auditing healthcare delivery processes based on accreditation standards.
Results: Findings revealed that the average fully met percentages resulted from the inpatient audit as per the priority focus areas were 65.8% Access to Care, 50% Finance, 73.8% Plan of Care, 75.45% Continuity of Care, 98.6% Patients and Family Rights, 80.5% Patient’s Safety, 64.5% Infection Prevention and Control, 95.6% Ethics and Attitudes, 96.4% communication, 53.55% other services, 81% Discharge. The mean inpatient audit score was M=106.96; SD 6.88 out of 120. Among the outpatient audit priority focus areas, the average of the fully met percentages were 68.2%% Access to Care, 54.5% Finance, 55.5% Patients and Family Rights, 70.45% Patient’s Safety, 62.7% Infection Prevention and Control, 94.9% Ethics and Attitudes, 94% communication, 59.1% Discharge. The outpatient audit score was M=69.18; SD 10.51 out of 84. Partners' characteristics were not significantly different among audit scores. Only the outpatient Audit Score for partners that performed the audit in OPD (mean: 74.8 points) was significantly higher than partners who performed the audit in other patient care units’ laboratory and MI (mean: 58.5 points) (mean: 63 points) respectively (p=0.005). We evaluated partners' experience through the PPEET. The mean of the PPEE score was M=54.96; SD 4.82. Out of 50 partners, 92.6% agree to strongly agree that there was communication and support for participation, 96.5% strongly agree with terms of sharing views and perspectives, 94.6% strongly agree with the positive impacts and influence of the engagement initiative, and 94% were satisfied with this engagement initiative.
Conclusion: Co-diagnosing partners introduced innovative perspectives for strengthening the healthcare system. The new approach must be tested in more depth before it can be determined whether it is superior to the conventional audit process.