Medical professionals have responsibilities that extend far beyond the hospital walls. Once patients are discharged, it is in their own hands to manage their condition and hopefully avoid readmission. But, it is the hospital’s responsibility to adequately prepare patients for this step in managing their conditions. If patients leave the hospital unprepared to manage their condition, the likelihood of readmission or return of symptoms is imminent.
However, the responsibility does not solely fall on providers. Patients play a big role in this preparation as well. It is up to them to ask the important questions and interact with hospital personnel to ensure they fully understand the nuances of their condition and care plan. But, in order to do this, they need to feel comfortable enough to speak up and engage with medical personnel.
This is where patient empowerment comes in to play. It is hard to pin down a set of rules for patient empowerment, because the exact strategies can vary based on the individual person and their condition. It is not something that a provider does to a patient, but rather a way of interacting that increases a patient’s self efficacy and confidence in managing their condition. The ultimate goal of patient empowerment is to prepare patients to make autonomous decisions regarding their care (Anderson & Funnell, 2010).
Why Patient Empowerment?
Of course, the short-term goal of patient empowerment efforts is to ensure patients are informed about their condition and can play an active role in care decisions. But, the impact of patient empowerment goes much further than the individual patient’s outcomes.
An immediate impact of patient empowerment is a smoother transition to home care, and thus fewer readmissions. Readmissions cost the healthcare system vast amounts of money each year, and oftentimes could be avoided if a patient were better prepared to manage their condition post-discharge. An empowered patient is an informed patient, and ideally will be educated enough to realize when a symptom can be handled in the home or when it requires additional medical attention. The ability to identify these “red flags,” that require a patient to contact a medical provider is a key component of the Care Transition Intervention (Coleman, Parry, Chalmers, & Min, 2006.)
Over time, patient empowerment can have a larger impact on a healthcare organization or the system at large. The European Patients Forum, a public health and patient advocacy organization, describes empowered patients as people who not only can handle their own conditions, but have the power to make a difference in the healthcare system. When patients are better educated and more involved with their care, they can provide more valuable feedback for organizations and on a systemic level. The best way to make changes that actually benefit patients and improve patient outcomes is by including them in the conversation, but they need to be well-informed and feel confident enough to do so.
How to Empower Patients
As previously discussed, patient empowerment is not one-size-fits-all. But, the overarching goal of patient empowerment, to prepare patients to make informed decisions about their care, remains the same. And although different strategies may be effective for different people, it all comes down to patient engagement and education.
At a basic level, this means fully reviewing a patient’s condition and treatment options with them, and making sure they understand what they need to do once they are discharged. But, it is not always so easy. A variety of psychosocial factors can make it difficult for patients to engage or feel empowered. A recent study showed that patients are more likely to adhere to their care plans when they perceive the patient/doctor relationship more positively (Graffigna, Barello, & Bonanomi, 2017).
How medical providers choose to interact with patients can have a huge impact on whether or not patient feels informed and empowered at the end of their hospital stay, and thus whether they are adequately prepared to manage their condition. Providers need to actually engage with patients rather than throwing facts at them. Only then will they feel comfortable to speak up and become active participants in planning their care.
Additionally, take note of any socioeconomic barriers patients may face when managing their condition postdischarge. It is useless to educate patients about follow-up treatment or postdischarge care that is not feasible for them. Hospital personnel need to look at the patient beyond their illness and use that information to develop a managed care plan that is realistic for the individual patient.
Some critics of patient empowerment initiatives point out that doctors and other providers are more prepared to make medical decisions, and thus they should hold the primary responsibility, not the patient. Patients generally are aware that healthcare providers are far more educated and knowledgeable about their condition than they themselves are. Patient empowerment does not shift the total responsibility of decision making to the patient, but rather provides them with education and information so that they have the autonomy to play an active role in their care. But, without a baseline of education and confidence in their knowledge, patients cannot actively participate in the decision making at all.
Employee Education for Patient Empowerment
Whether or not patients leave the hospital feeling empowered is in the hands of hospital personnel. Simply handing patients stacks of cookie-cutter handouts explaining things about their condition or management techniques is not enough. Providers need to involve patients in decisions about their care, and not use handouts as a substitute for real patient engagement.
Furthermore, hospital management needs to train their employees on the interpersonal skills necessary to recognize a patient’s needs and what styles of communications will work best for them. Simple actions like making eye contact with the patient can help them feel more connected to the providers and more willing to actively participate in their care.
It is essential that hospitals provide quality care to their patients, but “care” extends far beyond medical procedures. Hospital personnel should be trained not only in executing care, but in best practices for education and communication techniques in order to truly empower patients to play an active role in their treatment plan. Not only does patient empowerment benefit the patients themselves, but the hospital as a whole.