Table 2 Participants’ ratings of the proposed items
DOMAIN 1: Stakeholders | ||||
|---|---|---|---|---|
Type of stakeholders | ||||
Round 1 | Round 2 | |||
Item | Initial wording of the item | % of participants who thought these stakeholders should preferably or definitely be involved in completing the scale | Changes made in round 2 | % of participants who thought these stakeholders should preferably or definitely be involved in completing the scale |
a. | Senior Managers | 127 (97%) | reworded: Executives/Board of Directors | 70 (97%) |
b. | Junior Managers | 124 (95%) | reworded: Managers | 71 (99%) |
c. | Medical Clinicians | 129 (99%) | unchanged | 72 (100%) |
d. | Nurse Clinicians | 130 (99%) | unchanged | 72 (100%) |
e. | Other Health professionals* | 126 (96%) | unchanged | 72 (100%) |
f. | Receptionists | 99 (76%) | unchanged | 62 (86%) |
g. | Other staff in administration | 87 (66%) | unchanged | 57 (79%) |
h. | Other | 76 (58%) | unchanged | 47 (65%) |
Stakeholders’ characteristics | ||||
Round 1 | Round 2 | |||
Item | Initial wording of the item | % of participants who thought the item was important or very important | Changes made in round 2 | % of participants who thought the item was important or very important |
a. | Gender | 50 (38%) | unchanged | 34 (47%) |
b. | Age | 66 (50%) | unchanged | 38 (53%) |
c. | Length of employment | 80 (61%) | unchanged | 43 (60%) |
d. | - | - | new: Role in the organisation | 61 (85%) |
e. | - | - | new: Discipline (e.g. cardiology) | 49 (68%) |
f. | - | - | new: Ethnicity | 26 (36%) |
DOMAIN 2: The organisation’s willingness to implement patient engagement | ||||
Round 1 | Round 2 | |||
Item | Initial wording of the item | % of participants who thought the item was important or very important | Changes made in round 2 | % of participants who thought the item was important or very important |
a. | Informing patients about their condition or potential health issues | 126 (96%) | reworded: Engaging patients in discussing their condition or potential health issues | 72 (100%) |
b. | Informing patients about all available options, and the potential benefits and risks of each option | 128 (98%) | reworded: Discussing all relevant health care options with patients (including doing nothing), and the potential benefits and risks of each option | 71 (99%) |
c. | Actively checking patients’ understanding | 128 (98%) | unchanged | 72 (100%) |
d. | Encouraging patients to ask questions and voice concerns | 130 (99%) | unchanged | 72 (100%) |
e. | Engaging patients in collaborative decision-making | 129 (99%) | reworded: Encouraging patients to make health care decisions in partnership with the health care team | 71 (99%) |
f. | Engaging patients in positive health behaviours | 110 (84%) | unchanged | 61 (85%) |
g. | Eliciting patients’ preferences | 128 (98%) | combined with item h. and reworded: Asking patients about their health-related preferences and acting upon them | 71 (99%) |
h. | Taking patient preferences into account | 128 (98%) | combined with item g. | - |
i. | Providing patients with written information | 109 (83%) | combined with item j. and reworded: Supporting patients with additional health information resources (e.g. access to patient groups and decision support resources) | 67 (93%) |
j. | Providing patients with decision support tools | 111 (85%) | combined with item i. | - |
k. | Ensuring effective oral and written communication with diverse patients | 123 (94%) | reworded: Communicating with patients in a format that all patients can understand | 71 (99%) |
l. | Giving patients access to their medical information | 115 (88%) | reworded: Supporting patients to access their medical information in a format they can understand | 71 (99%) |
m. | Asking patients for feedback about their care experiences | 124 (95%) | reworded: Asking patients for feedback about their care experiences and acting upon it | 70 (97%) |
n. | Engaging patients as advisors in the organisation | 114 (87%) | reworded: Engaging patients as partners in the organisation in all areas of health care services (e.g. design, delivery, and evaluation) | 61 (85%) |
o. | - | - | new: Treating patients as partners, with respect and consideration for their individual needs, throughout their care journey, from entering the building to receiving reatments etc. | 71 (99%) |
p. | - | - | new: Developing care plans as a partnership between health professionals and patients with long term conditions (e.g. defining mutually agreed goals, actions, and timeframes) | 71 (99%) |
DOMAIN 3: The organisation’s ability to implement patient engagement | ||||
Tasks | ||||
Round 1 | Round 2 | |||
Item | Initial wording of the item | % of participants who thought the item was important or very important | Changes made in round 2 | % of participants who thought the item was important or very important |
a. | Developing a shared organisational vision for patient engagement | 126 (96%) | reworded: Developing a shared organisational vision for patient engagement among employees and patients | 70 (97%) |
b. | Getting ownership of a shared organisational vision for patient engagement | 107 (82%) | reworded: Sharing the organisational vision for patient engagement with all employees | 69 (96%) |
c. | Sharing the organisational vision for patient engagement with all patients | 114 (87%) | reworded: Sharing the organisational vision for patient engagement with all patients and the public (e.g. information in waiting areas) | 66 (92%) |
d. | Including patient engagement in policies, processes, position descriptions and training programs | 119 (91%) | reworded: Including patient engagement in all areas of health care services (e.g. policies, processes, position descriptions and training programs) | 68 (94%) |
e. | Tailoring communication to individual patients’ needs | 126 (96%) | removed because this item is covered in domain 2 | - |
f. | Tailoring consultations to individual patients’ needs | 123 (94%) | removed because this item is covered in domain 2 | - |
g. | Supporting all employees in their efforts to promote patient engagement | 128 (98%) | reworded: Supporting employees in their efforts to promote patient engagement (e.g. asking what they need and addressing these needs, reminders) | 71 (99%) |
h. | Monitoring patient engagement in the organisation | 124 (95%) | reworded: Monitoring patient engagement in the organisation and giving feedback to employees | 72 (100%) |
i. | Solving problems that arise during the implementation of patient engagement | 128 (98%) | unchanged | 72 (100%) |
Resources | ||||
Round 1 | Round 2 | |||
Item | Initial wording of the item | % of participants who thought the item was important or very important | Changes made in round 2 | % of participants who thought the item was important or very important |
a. | Expertise in patient engagement | 118 (90%) | reworded: Access to expertise in patient engagement | 71 (99%) |
b. | Time for initial implementation of patient engagement | 123 (94%) | reworded: Time for initial implementation of patient engagement (e.g. time to inform employees about patient engagement processes) | 70 (97%) |
c. | Time for monitoring implementation of patient engagement | 125 (95%) | reworded: Time for monitoring implementation of patient engagement (e.g. time for employees to provide feedback) | 69 (96%) |
d. | Time to make patient engagement happen | 125 (95%) | reworded: Time to make patient engagement happen (e.g. revising targets and objectives, longer consultations) | 72 (100%) |
e. | Communication skills training | 121 (92%) | combined with item f. and reworded: Training health professionals in patient engagement (e.g. communication and shared decision-making skills) | 72 (100%) |
f. | Training in patient engagement and shared decision-making skills | 128 (98%) | combined with item e. | - |
g. | Patient education materials in a language the patient can understand | 123 (94%) | combined with item h. and i. and reworded: Resources to provide health-related information and support to patients (e.g. access to interpreters, answering questions, helping patients to make decisions) | 72 (100%) |
h. | Decision support resources | 113 (86%) | combined with item g. and i. | - |
i. | Trained medical interpreters and care coordinators | 105 (80%) | combined with item g. and h. | - |
j. | Systems and processes that can identify and adapt to diverse patients’ needs | 116 (89%) | reworded: Systems and processes that can adapt to diverse patients’ needs (e.g. scheduling of appointments) | 68 (94%) |
k. | - | - | new: Access to patient representatives | 57 (79%) |
l. | - | - | new: Resources to support patients in becoming partners (e.g. recruitment of representatives, training, coaching, money to pay patients for participation) | 59 (82%) |
m. | - | - | new: Tools to evaluate the implementation of patient engagement | 68 (94%) |
Situational factors | ||||
Round 1 | Round 2 | |||
Item | Initial wording of the item | % of participants who thought the item was important or very important | Changes made in round 2 | % of participants who thought the item was important or very important |
a. | Alignment of patient engagement with organisational priorities | 123 (94%) | unchanged | 68 (94%) |
b. | Timing of the implementation of patient engagement | 105 (80%) | removed because this is already covered by item a. | - |
c. | Employee attitudes, beliefs, and experiences regarding patient engagement | 126 (96%) | unchanged | 70 (97%) |
d. | Positive and consistent communication about patient engagement | 126 (96%) | reworded: Frequent and consistent communication about patient engagement | 69 (96%) |
e. | Employee involvement in planning the implementation of patient engagement | 127 (97%) | reworded: Employee involvement in planning, implementation, and monitoring of patient engagement | 71 (99%) |
f. | Patient involvement in planning the implementation of patient engagement | 117 (89%) | reworded: Patient involvement in planning, implementation, and monitoring of patient engagement | 70 (97%) |
g. | Performance measures include patient engagement | 120 (92%) | unchanged | 66 (92%) |