Improving Hospital Outcomes through Patient Engagement:  The i-HOPE Study

Overview

We have partnered with our patients and other stakeholders to improve the care and experiences of hospitalized patients through:

  1. Generating a patient-centered research agenda
  2. Creating a network of stakeholder collaborators

This research agenda and network could be used by patients, stakeholders, advocacy groups, and researchers to advance the care of hospitalized patients in the United States and beyond.

Download Stakeholder Webinar Presentation to learn more about the Study.

Background

Despite the fact that millions of patients are hospitalized each year, significant gaps in care exist. These include gaps in safety such as medication errors and hospital-associated complications, inconsistent delivery of evidence-based care, and poor care transitions.

Since the Institute of Medicine Report “To Err is Human,” increased attention has been paid to improving the care of hospitalized patients. Specific improvement strategies include utilization of guidelines, pathways, checklists, and the application of quality improvement techniques to improve processes.

Despite improvements in focused areas such as prevention of hospital-acquired infections, evidence suggests that systematic improvements in outcomes of hospitalized patients have not been achieved. Rates of errors and hospital-related complications remain high, and not all patients receive the care known to be appropriate for their illnesses.

Diverse studies report that twenty 20 to thirty 30 percent of hospitalized patients experience errors in care. Finally, care transitions are recognized as a particularly vulnerable time in terms of communication failures. Despite significant attention being paid to the area of care transitions, including financial penalties for readmissions, they remain a stubborn and difficult problem.

Additionally, hospitalization can be an overwhelming experience for patients and families. There are many reasons for this: they are sick, often with symptoms whose causes may be unclear; they are cared for by many different providers with whom they do not have relationships; they experience complications, adverse events, and errors in care; and they may be discharged without clear instructions or follow-up plans for care. These issues are well-documented in the medical literature. What is less clear is where patients’ and families’ priorities lie to address them.

To better understand patients’, families’, and other stakeholders’ perspectives on the most important gaps in hospital care, we propose a systematic engagement process followed by an in-person prioritization meeting that sets the stage for future research and collaboration. The need and rationale for our proposal is clear: patients’ voices must be at the forefront of this work, and to date they have been largely absent.

The inclusive, iterative approach to identification of unanswered questions and their prioritization will ensure that patients’ and stakeholders’ voices are clearly heard, and that the in-person meeting will result in an actionable list of research priorities with a robust dissemination plan. This group of patient, family, and stakeholder participants can also form the basis for a network of stakeholder collaborators for future research.

Project Timeline

Research Agenda

More information to come.

Steering committee

The i-HOPE Steering Committee consists of hospitalist researchers and patient partners. Please see biographies for each member by clicking on his or her name.

SHM RC Member

Patient Partner

“Home” Organization

Luci Leykum

Esther Avitia

South Texas Veterans Health Care System / UT Health San Antonio

Marisha Burden

Michelle Archuletta

Denver Health

Vineet Chopra

Georgianne Ziegler

The University of Michigan

Shaker Eid

Julie Hagan

Johns Hopkins Bayview Medical Center

Margaret Fang

Jim Banta

The University of California at San Francisco

Kathlyn Fletcher

 

Medical College of Wisconsin /
Clement J. Zablocki VA Medical Center

Wally Jaranilla

Cindy Bultena

Joy Benn

Lali Silva

HealthEast Care System

Monalisa Mullick

Melissa Wurst

Washington University in St. Louis

 

The Steering Committee will work with our patient and stakeholder partners, as well as the Society of Hospital Medicine, to develop the research agenda.



Patients and Stakeholders

Project Orientation Document

Download Stakeholder Webinar Presentation to learn more about the Study.

Interim Results

More information to come.



Questions or Comments, please email i-Hope@uthscsa.edu

The i-HOPE Study project is funded through the Patient-Centered Outcomes Research Institute Eugene Washington PCORI Engagement Award EAIN-3939.