Real-time patient advisory groups’: Novel opportunities for learning and improvement
Gaetan Tardif

At a time when there is great emphasis on patients’ experiences of care and their engagement across the health spectrum, the development and implementation of ‘real-time groups’ offers a method of patient engagement to better understand their experiences, and to use these experiences to guide patient-centred improvements. These real-time groups have provided a structured, yet informal process that allows patients currently receiving care and their families to share their experiences, and is a flexible approach that can be adapted for a myriad of healthcare settings.  Importantly, we have also instituted processes to share this feedback from groups with staff and leaders, to generate discussion about opportunities for improvement that have led to a number of changes aimed to enhance the patient experience of care within our rehabilitation settings.

This project aimed to engage patients and families to enhance their experience of care in a rehabilitation setting, It was guided by 2 main objectives: 1)  to develop ‘real-time patient advisory groups’ as an informal yet structured mechanism to obtain patient feedback; and 2) to develop a model for using this feedback for learning and patient-centred improvement.  Relevance: Real-time groups offer an innovative way to bring together 2 strategies for engaging patients: developing advisory groups and obtaining feedback in real-time. Methods: Developmental evaluation using mixed methods assessed both the process of engagement and outcome of these groups using surveys, interviews and focus groups with patients and clinicians over multiple timepoints. Descriptive statistics and thematic analysis were conducted. Results: 220 inpatients, outpatients and family members participated in 24 real-time groups, discussing experiences of care on a wide range of topics. Key emerging themes included the value of peer support and information sharing; collective voice powerful for action; and closing the loop as essential to build partnerships. Multiple improvement opportunities have been generated by these groups, including education materials, processes related to admission and discharge, communication, and care coordination – all with the goal to enhance experience of care. Discussion and Conclusion: Key enablers have included creating a comfortable environment to generate open discussion about experiences, the importance of staff, as well as patient engagement, developing strong communication processes, and strong and visible leadership. Being responsive to feedback and accountable for actions has been paramount to foster a culture of partnership among patients and staff for quality and safety to enhance the patient of care.