Intermountain also has established a patient and family advisory council that regularly weighs in on issues related to patient engagement. For instance, hospital leaders recently sought the council's feedback on asking hospital patients to sign a form stating they would not get out of bed without first calling a nurse. The council said fine—as long as the hospital pledged that a nurse would be in the room within five minutes of the call. “It's a two-way commitment,” Richards said.
A year ago, Intermountain launched a shared-decisionmaking pilot to test ways to better engage patients. Funded by a grant from the CMS Innovation Center, the multisite pilot assesses patients being treated for five conditions, including total joint replacement and diabetes, at Intermountain's clinics run by its employed physicians. The goal is to see how patients' views and decisions are affected by enhanced education tools and support.
“We're evaluating things like, 'How well do you understand the information?' 'Do you feel like you had enough information?' and 'Did your decision change based on that information?' ” Henrichsen said.
Results from the pilot are just starting to trickle in. Of the first 170 patients to receive the additional education, 21% changed decisions about their care. Some pursued more-aggressive treatments and some less aggressive ones, Richards said.
Intermountain has been emphasizing the importance of shared decisionmaking and shared accountability across the system. That has met with pockets of resistance.
“This is an area that is still difficult for some providers,” Richards said.
In the pilot, some really understood shared decisionmaking and bought into it, while others said, “I just don't have time for this,” or “My patients just want me to tell them what to do.” It will continue to be a challenge, she added, because of financial incentives and patient expectations. “But we're making progress.”
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