I wish my partner would carry his load. How do I get my kid to clean his room? She never cooks! How do I get her to talk to me? People in relationships complain and scold – expecting the other person to change and do whatever. Makes me cranky. Relationships are a two-way street in a setting with values, habits, and pressures. My kids once gave me a button for my hat: Cuz I’m the Dad. That’s Why! I have been resoundingly unsuccessful over 60+ years getting someone else to change at pretty much anything.
Much buzz now in health care about patient engagement. How do we get patients more engaged? Makes me cranky in the same way. Engagement is also about relationships. Relationships between people often perceived as unequal, in a less than safe and supportive setting, expecting others to change. So, engagement is patients and their personal care partners in a relationship with clinicians and their support staff, communicating wherever and however, within a setting with empowering values and habits (or not), with information and technology accessible and understandable (or not).
An engaged patient is equipped, enabled, empowered, and participating in their health and health care decisions. Not only do groups of people vary in levels of engagement, individual engagement varies from moment to moment and scenario to scenario. Culture and community make a difference, as do stage of health – new or chronic, annoying or life-threatening. As in families, engagement is dynamic, not static.
An engaged clinician is empathetic, empowering, and equipped to inform, educate, and communicate with people in their care. Their engagement is also dynamic depending on their own skills, the capabilities of their patients and the time, workflow, and technology stresses of their jobs.
Healthcare leaders have the most impact on the setting of patient and clinician engagement. They model listening, empathy, and conducting difficult conversations. They clarify accountabilities, prioritize investment in tools and technology, and reward desired behaviors for a safe environment. Cuz I’m the Dad doesn’t work for them either.
Engaged patients need engaged health care providers. You are right, Danny. It’s a relationship, an on-going and evolving dialogue.