title: Patient and family engagement: a survey of US hospital practices.
abstract: BACKGROUND
  Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known.
  
  
  OBJECTIVE
  We report on a survey of hospitals in the USA regarding their PFE practices during 2013-2014.
  
  
  RESULTS
  The response rate was 42%, with 1457 acute care hospitals completing the survey. We constructed 25 items to summarise the responses regarding key practices, which fell into three broad categories: (1) organisational practices, (2) bedside practices and (3) access to information and shared decision-making. We found a wide range of scores across hospitals. Selected findings include: 86% of hospitals had a policy for unrestricted visitor access in at least some units; 68% encouraged patients/families to participate in shift-change reports; 67% had formal policies for disclosing and apologising for errors; and 38% had a patient and family advisory council. The most commonly reported barrier to increased PFE was 'competing organisational priorities'.
  
  
  CONCLUSIONS
  Our findings indicate that there is a large variation in hospital implementation of PFE practices, with competing organisational priorities being the most commonly identified barrier to adoption.
authors.affiliation: Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA Division of Cardiology, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Jeph
authors.initials: J
authors.lastname: Herrin
authors.affiliation: Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA.
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Harris
authors.affiliation: Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kenward
authors.affiliation: Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hines
authors.affiliation: Health Research & Educational Trust, American Hospital Association, Chicago, Illinois, USA.
authors.forename: Maulik S
authors.initials: MS
authors.lastname: Joshi
authors.affiliation: Gordon & Betty Moore Foundation, Palo Alto, USA Department of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Dominick L
authors.initials: DL
authors.lastname: Frosch
mesh_terms: D000066491:Clinical Decision-Making; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010358:Patient Participation / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000458:organization & administration*; D011368:Professional-Family Relations; D014481:United States
keywords: Healthcare quality improvement; Leadership; Patient-centred care