Article Title

Pathway to Measuring Patient and Family Engagement: Prioritizing Engagement Behaviors in the Hospital Setting

Publication Date



patient and family engagement, hospital quality improvement


Background/Aims: Growing evidence suggests that patient and family engagement (PFE) can help achieve the “Triple Aim” of improving population health and patient experiences of care while reducing costs. One critical gap as we work toward these goals is the lack of a clear approach to PFE measurement to assess associated outcomes and gauge health care performance. In this project, we draw on an existing framework to define behaviors that constitute PFE in the hospital setting and identify a subset of these behaviors that are of high priority for measure development and implementation.

Methods: We identified engagement behaviors for hospital leadership, clinicians and patients/families through: a literature scan of publications and existing measures; key informant interviews; and input from an eight-member advisory group that included patients and families, clinicians, measurement experts and hospitals. To prioritize engagement behaviors, we categorized these behaviors into thematic domains, surveyed our advisory group and other experts in PFE and synthesized feedback to select a set of high-priority behaviors for PFE measurement that address multiple domains, are feasible to measure and are important for driving change or increasing accountability.

Results: Eight domains of engagement in the hospital setting were prioritized: access to medical record, creating opportunities for engagement, communication, discharge planning, family presence, goal-setting, shared care planning, and transparency. These domains include specific high-priority engagement behaviors at the hospital, clinician and patient levels. For example, priority behaviors in the “access to medical record domain” include: hospitals make medical records easily accessible and involve patients and families in designing medical record access mechanisms and policies; clinicians record patient medical information in plain language (free of jargon and abbreviations); and patients access and use their medical record.

Conclusion: PFE measurement is at a nascent stage. To our knowledge, this is the first work to systematically identify behaviors that constitute PFE in the hospital setting and prioritize those that are feasible and important to measure. The resulting matrix of high-priority measurement behaviors mapped against domains and levels of PFE provides a comprehensive approach for measuring PFE in the hospital setting, including the selection and development of measures.




July 5th, 2016


August 12th, 2016