title: Patient engagement in clinical communication: an exploratory study.
abstract: OBJECTIVE
  Existing practice strategies for actively involving patients in care during hospitalisation are poorly understood. The aim of this study was to explore how healthcare professionals engaged patients in communication associated with care transitions.
  
  
  METHODS
  An instrumental, collective case study approach was used to generate empirical data about patient transitions in care. A purposive sample of key stakeholders representing (i) patients and their families; (ii) hospital discharge planning team members; and (iii) healthcare professionals was recruited in five Australian health services. Individual and group semi-structured interviews were conducted to elicit detailed explanations of patient engagement in transition planning. Interviews lasted between 30 and 60 minutes and were digitally recorded and transcribed verbatim. Data collection and analysis were conducted simultaneously and continued until saturation was achieved. Thematic analysis was undertaken.
  
  
  RESULTS
  Five themes emerged as follows: (i) organisational commitment to patient engagement; (ii) the influence of hierarchical culture and professional norms on patient engagement; (iii) condoning individual healthcare professionals' orientations and actions; (iv) understanding and negotiating patient preferences; and (v) enacting information sharing and communication strategies. Most themes illustrated how patient engagement was enabled; however, barriers also existed.
  
  
  CONCLUSIONS
  Our findings show that strong organisational and professional commitment to patient-centred care throughout the organisation was a consistent feature of health services that actively engaged patients in clinical communication. Understanding patients' needs and preferences and having both formal and informal strategies to engage patients in clinical communication were important in how this involvement occurred.
authors.affiliation: NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Research Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
authors.affiliation: Centre for Health Practice Innovation, Menzies Health Research Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: McMurray
authors.affiliation: NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Research Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marshall
authors.affiliation: NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Research Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Brigid
authors.initials: B
authors.lastname: Gillespie
authors.affiliation: NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Research Institute Queensland, Griffith University, Gold Coast, Qld, Australia.
authors.forename: Shelley
authors.initials: S
authors.lastname: Roberts
authors.affiliation: Centre for Nursing Research Deakin University-Monash Health Partnership, Melbourne, Vic., Australia.|School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Hutchinson
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.|Epworth Health Care: Centre for Clinical Nursing Research, Melbourne, Vic., Australia.
authors.forename: Mari
authors.initials: M
authors.lastname: Botti
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: McTier
authors.affiliation: Centre for Nursing Research Deakin University-Monash Health Partnership, Melbourne, Vic., Australia.|School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Rawson
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.|Deakin & Alfred Health Nursing Centre for Research, Melbourne, Vic., Australia.
authors.forename: Tracey
authors.initials: T
authors.lastname: Bucknall
mesh_terms: D003142:Communication; D006801:Humans; D010358:Patient Participation
keywords: clinical communication; patient engagement; patient participation; patient-centred care; person-centred care; transitions in care