Nursing Experts Release Guiding Principles for Patient Engagement

Nursing Alliance for Quality Care kicks off effort to put the patient relationship at the cornerstone of patient safety and quality.

Jul 11, 2012

The Nursing Alliance for Quality Care (NAQC) released Guiding Principles for Patient Engagement, a list of nine core principles designed to support nurses and other health care providers in delivering high-quality, patient-centered care.

The principles, developed by a committee of nurse leaders and patient advocates, are meant to guide the provider community in developing patient engagement models and quality and safety interventions that support and encourage the patient and family to become partners in their care. The development of the principles, and the organization, is supported by the Robert Wood Johnson Foundation, the nation’s largest health care philanthropy.

“These principles are a building block to spur nurses and other providers to improve the full engagement of patients in the care they receive, and will be key to consider as hospitals, clinics and long-term care settings across the country seek to improve the quality and safety of the care they deliver,” said Mary Jean Schumann, executive director of the Nursing Alliance for Quality Care. “Many of these principles are already at the core of what we do as nurses, but we need to make sure that our field is systematically keeping the patient at the center of all health care efforts. We believe that the principles will spark a dialogue among practicing nurses, nurse educators, students, and other providers, leading to policy initiatives that create dramatic changes that support the integrating of patients and families fully in all care decisions.”

The principles include:

• There must be a dynamic partnership among patients, their families, and the providers of their health care, which at the same time respects the boundaries of privacy, competent decision-making, and ethical behavior.
• This relationship is grounded in confidentiality, where the patient defines the scope of the confidentiality. Patients are the best and ultimate source of information about their health status and retain the right to make their own decisions about care.
• In this relationship, there are mutual responsibilities and accountabilities among the patient, the family, and the provider that make it effective.
• Providers must recognize that the extent to which patients and family members are able to engage or choose to engage may vary greatly based on individual circumstances. Advocacy for patients who are unable to participate fully is a fundamental nursing role.
• All encounters and transactions with the patient and family occur while respecting the boundaries that protect recipients of care as well as providers of that care.
• Patient advocacy is the demonstration of how all of the components of the relationship fit together.
• This relationship is grounded in an appreciation of patient’s rights and expands on the rights to include mutuality.
• Mutuality includes sharing of information, creation of consensus, and shared decision-making.
• Health care literacy is essential for patient, family, and provider to understand the components of patient engagement. Providers must maintain awareness of the health care literacy level of the patient and family and respond accordingly. Acknowledgment and appreciation of diverse backgrounds is an essential part of the engagement process.

The release of the principles is the first component of the alliance’s effort to enhance nurses’ attitudes and behaviors that foster the engagement of patients in their care. Over the next few months, NAQC will be discussing how to implement the principles with the nation’s leading nursing organizations, patient advocates, and other provider groups. In November, NAQC will host a conference on the topic to spark discussion of how to move from principles to practical models of care delivery. More information about the conference and a call for posters is available at www.NursingAQC.org.

“We hope that nursing organizations, nursing programs, medical schools, and others will use these principles to inform their members and students and integrate patient engagement into their programs and practices,” said Pamela Thompson, chief executive officer of the American Organization of Nurse Executives and chair of the subcommittee that drafted the principles. “I was a part of the committee that designed the principles and throughout the process we reminded ourselves that keeping the patients’ best interests in mind was at the core of our mission, but to do that we needed to give providers guidelines for how to effectively involve patients in their care.”

NAQC, an alliance funded through a combination of grants, membership dues, and program fees, is based at The George Washington University School of Nursing in Washington, D.C.
NAQC Members

• American Association of Colleges of Nursing
• American Academy of Nursing
• AARP
• American College of Nurse-Midwives
• American Nurses Association
• American Organization of Nurse Executives
• American Academy of Nurse Practitioners
• Association of Nurses in AIDS Care
• Association of periOperative Registered Nurses
• Consumers Advancing Patient Safety
• Institute of Pediatric Nursing
• Mothers Against Medical Error
• National Council of State Boards of Nursing
• National League for Nursing
• National Organization of Nurse Practitioner Faculties
• National Quality Forum
• Nurse-Family Partnership

Copyright 2012 The Robert Wood Johnson Foundation http://www.rwjf.org
The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care.