Patient involvement in healthcare
One of the drivers for increased patient involvement in medical education is the increasing acknowledgement of the ‘patient voice’ in healthcare. This in turn reflects a wider involvement of service users and carers, and the ‘personalisation’ of care at all levels in public services (Carr and Dittrich, 2008, p. 4). This shift towards a partnership and personalised care agenda, enshrining choice and located around local services, has changed the role of health professionals towards being not only practitioners and leaders, but also partners in care.
Two streams of lay involvement in healthcare services have emerged: patient involvement as the contribution of individuals to clinical decisions about their own healthcare and that of others in similar circumstances, and public involvement via the participation of individuals or groups in the development, planning and provision of services. Clinical and non-clinical decision-making are different; however, areas of overlap exist in clinical governance, quality assurance, regulation, education and research.
Work looking at the effectiveness of user involvement in the evaluation and development of services reports a positive effect on the patient/client/user experience.
- partnership groups show effective achievements including improvements in information, communication of bad news, transportation, parking, waiting times and building design
- strong leadership is crucial
- the commitment of health professionals, organisations and service users is key to sustainability of patient involvement
- health professionals may experience emotional and interpersonal challenges when working with patients/carers
In education, patients and service user groups are routinely involved in the clinical learning process and increasingly in other aspects of education such as curriculum design and review, university-based teaching and assessment. Their role is wider than simply being a person with signs and symptoms, but in providing the service user perspective on healthcare delivery and improvement.
An interprofessional learning day involving first-year medical, nursing and paramedic students around the theme of ‘Dignity in healthcare’ involved service users (patients and carers) in the development and delivery of the day. Students and staff found it hugely moving and powerful to hear stories from the service users and many students vowed this would change their practice forever.