Developing a Community-Based Patient Safety Advisory Council

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Chapter 2. Patient Safety Advisory Councils

The success of any team requires active participation from every member. The approach health care systems traditionally take neglects the most critical member of the team—the patient. Programs and policies are developed without patient input. Hospital rounds are conducted around the patients. Schedules and processes are created to meet the needs of the health care providers. This provider-centric approach does not view the patient as an engaged team member.

There is a new wave of consumers who have heard stories of or actually experienced errors, mistakes, and failures in hospitals, clinics, and pharmacies. These patients, families, community members, and employers may not understand all the complexities of the health care system, but they want to be part of the team working to correct it. And some health care providers who realize the importance of the patient perspective are inviting them into their hospitals and offices to help transform the system. Embodied by a collaborative consumer-provider relationship, these providers are transforming their culture to promote patient-centered care.¹

One formal approach to engaging patients in programs and processes is through patient advisory councils.^2,3 Several health care organizations have been recognized for involving patients on councils, teams, and even board committees, including Dana Farber Cancer Institute, Boston, Massachusetts; Cincinnati Children's Hospital, Cincinnati, Ohio; and Children's Hospitals and Clinics, Minneapolis/St. Paul, Minnesota. However, few councils have been created with a primary focus on patients who receive care in outpatient settings, such as clinics, retail pharmacies, or community-based health programs.

This guide describes the steps Aurora Health Care took to create a community-based patient safety council focused on improving medication safety for the outpatient population. It provides the tools needed to create a patient advisory council in your community. Using these resources, you will have all the components to build a successful team.

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Background

Aurora Health Care, an integrated delivery system in Wisconsin, has 13 hospitals, more than 100 clinics, more than 120 retail pharmacies, and a home health program. For years, Aurora worked to improve safety across the continuum of care. Though Aurora staff had "talked the talk" about patient-centered care, they had not formally included patients in any team or project. As they struggled with an initiative to improve medication safety in the outpatient setting, they realized that patients' perspectives were missing. In 2005, Aurora Health Care received funding from the Agency for Healthcare Research and Quality (AHRQ) to incorporate lessons learned from inpatient examples of patient advisory councils into the implementation of an outpatient-based patient safety council.

The objective of the project was to create a place where patients and health care providers could openly discuss the barriers to and opportunities for a safe, effective medication process in the outpatient setting. The project was developed on the premise that a collaborative process, with patients and providers working together, would lead to the development of effective interventions that could be disseminated and adopted throughout the community.

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Benefits of Involving Patients

Creating a patient safety advisory council benefits patients, the health care organization, and the provider.

Benefits for patients include:

Becoming more aware and better educated on the subject.
Gaining a better understanding of the health care system, including their organization.
Appreciating being part of the program, listened to, and having their opinions valued.
Becoming advocates for their organization.
Understanding how to be an active participant in their own health care.
Recognizing that collaboration with their providers through patient-centered care leads to better self-management of chronic conditions and improved adherence to medication regimens.
Learning to be advocates for their family and friends.

Benefits for health care organizations include:

Learning what the priority concerns are for patients, which may not be what the organization selects.
Hearing directly from their customers, the patients.
Transforming their culture toward patient-centered care.
Developing programs and policies that are relevant to their patients' needs.
Improving consumer satisfaction, which leads to stronger patient loyalty.
Strengthening their community relations.

Benefits for providers include:

Becoming more aware of the patient's perspective.
Learning to provide care from a patient-centered approach.
Recognizing the role of other caregivers, such as family and friends.
Appreciating barriers—and opportunities—for patients that were previously not understood.
Identifying system issues that need to be addressed to provide patient-centered care.
Receiving higher satisfaction ratings by their patients as they collaborate in a patient-centered care model.¹

^1. Aspden P, Wolcott JA, Bootman L, Cronenwelt LR. eds. Institute of Medicine, Preventing Medication Errors, Quality Chasm Series. Washington, DC: The National Academies Press, 2007.
^2. Webster PD, Johnson BH. Developing and Sustaining a Patient and Family Advisory council. Bethesda, MD. Institute for Family-Centered Care. 2000.
^3. Ponte PR, Conlin G, Conway JB, et al. Making patient-centered care come alive: Achieving full integration of the patient's perspective. J Nurs Admin 2003;33:82-90.

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