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Patients and family members possess a wealth of information about their illness and about what works in the healthcare system. But unless healthcare providers experience a patient's illness firsthand or invite patients to share their ideas and perspectives, their knowledge and insight will go untapped, says patient and family-centered quality improvement expert Susan Edgman-Levitan, PA, executive director of the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital in Boston and founding president of the Picker Institute.

Speaking at a recent nursing conference hosted by the Boston-based Institute for Nursing Healthcare Leadership and the Center for Nursing Outcomes Research at the University of Pennsylvania, Edgman-Levitan urged nurses and other healthcare providers to "rampup" how they partner with patients and families. Besides involving them in the care process, she said, providers also should engage patients and family members in program planning activities.

Partnering with patients and families during a hospitalization is especially important. "Patients are in our care for a very short time," she says. "Before they are hospitalized and after they are discharged, they are managing their care on their own."

The care team gains a better understanding of patients' illnesses and self-care needs by involving patients and their families in the care process, which helps them better prepare for discharge.

Reviewing the plan of care clinical pathways with patients and families is a good place to start. "This not only helps patients and families know what tests and treatments to expect, but also allows patients to prepare for key events like discharge," says Edgman-Levitan. Discussing the plan of care also prompts a dialogue in which patients and families might share new information of which the care team may not be aware.

Edgman-Levitan believes involving patients and families in rounds and offering patients the chance to review their own medical records and progress notes also is a good idea. "It is not uncommon for patients to spot critical errors in the record about things like medications and allergies," she says. By participating in rounds, patients and family members have a chance to discuss their observations about care and how the patient responded to aspects of treatment — information that can be critical in planning the next steps in care.

An easy way to engage patients in their own care is to offer them choices, says Edgman-Levitan. The choices can be about simple things, such as whether they would like an IV in their right or left hand or whether they would like the door to their room open or closed.

"Giving patients choices helps them feel they are in control and tells them you care about them and respect them," says Edgman-Levitan.

She also recommends adopting a practice of hourly rounding in which a nurse or another member of the staff checks on patients to see if they need anything. Rounding also enhances the connection between patients and staff. Some units have discovered it also can lead to a marked decrease in call-light volume, since patients' needs are already met.

Partnering with patients and families also should happen at the program and institutional level, says Edgman-Levitan, noting, "If we don't talk to patients and families, we will spend a tremendous amount of time and money designing programs that don't have the impact we had hoped for."

The input and insights of patients and families can benefit many aspects of care, from the look and content of informational materials to the design of patient care units and buildings to the quality of admitting and discharge systems. One way to assure paients' voices are heard, says Edgman-Levitan, is to create a patient and family advisory council that consults on institutional plans and initiatives. When choosing council members, she recommends looking for patients and family members who are good communicators and listeners and who are able to consider a range of patient experiences.

Edgman-Levitan also encourages organizations to involve patients and families in employee and faculty training programs. "The stories patients tell are powerful motivators," she says. "Unlike reports and data summaries that end up on some shelf, patients' stories stay with staff for a long time and serve as constant reminders for how we can do things differently and change things for the better."

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Beth Kantz is a freelance writer. To comment, e-mail editorNTL@gannetthg.com.