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How might patient involvement in healthcare quality improvement efforts work—A realist literature review
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-1281-7918
Jönköping University.ORCID iD: 0000-0003-1814-4478
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-7117-9808
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-8807-0876
2019 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 00, no 00, p. 1-13Article in journal (Refereed) Published
Abstract [en]

Introduction This realist literature review, regarding active patient involvement in healthcare quality improvement (QI), seeks to identify possible mechanisms that contribute to success or failure. Furthermore, the paper outlines key considerations for organising and supporting patient involvement in healthcare QI efforts.

 

Methods Two literature searches were performed. Altogether, 1,204 articles from a healthcare context were screened, focusing on improvement efforts that involve patients, healthcare professionals and/or managers and leaders. Among these, 107 articles fulfilled the chosen study selection criteria and were further analysed. 18 articles underwent a full realist review. In the realist synthesis, context-mechanism-outcome configurations were articulated as middle-range theories and organised thematically to generate a program theory on how active patient involvement in QI efforts might work.

 

Results The articles exhibited a diversity of patient involvement approaches at different levels of healthcare organisations. To be successful, organisations’ support of QI efforts that actively involved patients tailored the QI efforts to their context to achieve the desired outcomes, and involved the relevant microsystem members. Furthermore, it promoted interaction and partnership within the microsystem, and supported the behavioural change that follows.

Conclusion This realist synthesis generates a program theory for active patient involvement in QI efforts; active patient involvement can be a tool (resource), if tailored for interaction and partnership (reasoning), that leads to behaviour change (outcome) within healthcare QI efforts. The theory explains essential resource and reasoning mechanisms, and outcomes that together form guidance for healthcare organisations when managing active patient involvement in QI efforts.

Place, publisher, year, edition, pages
2019. Vol. 00, no 00, p. 1-13
Keywords [en]
clinical microsystem, co‐design, co‐production, healthcare management, healthcare organization, patient involvement, quality improvement, realist review
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-21020DOI: 10.1111/hex.12900OAI: oai:DiVA.org:hb-21020DiVA, id: diva2:1316217
Available from: 2019-05-16 Created: 2019-05-16 Last updated: 2019-05-24Bibliographically approved

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Bergerum, CarolinaJosefsson, KarinWolmesjö, Maria

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