A Narrative Review of Patient and Family Engagement: The "Foundation" of the Medical "Home".
BACKGROUND
Patient and family engagement (PFE) is vital to the spirit of the medical home. This article reflects the efforts of an expert consensus panel, the Patient and Family Engagement Workgroup, as part of the Society of General Internal Medicine's 2013 Research Conference.


OBJECTIVE
To review extant literature on PFE in pediatric and adult medicine and quality improvement, highlight emerging best practices and models, suggest questions for future research, and provide references to tools and resources to facilitate implementation of PFE strategies.


METHODS
We conducted a narrative review of relevant articles published from 2000 to 2015. Additional information was retrieved from personal contact with experts and recommended sources from workgroup members.


RESULTS
Despite the theoretical importance of PFE and policy recommendations that PFE occurs at all levels across the health care system, evidence of effectiveness is limited, particularly for quality improvement. There is some evidence that PFE is effective, mostly related to engagement in the care of individual patients, but the evidence is mixed and few studies have assessed the effect of PFE on health outcomes. Measurement issues and the lack of a single comprehensive conceptual model pose challenges to progress in this field. Recommendations for future research and a list of practical tools and resources to facilitate PFE are provided.


CONCLUSIONS
Although PFE appeals to patients, families, providers, and policy-makers, research is needed to assess outcomes beyond satisfaction, address implementation barriers, and support engagement in practice redesign and quality improvement. Partnering with patients and families has great potential to support high-quality health care and optimize outcomes.
*Division of General Internal Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC †Institute for Patient- and Family-Centered Care, Bethesda, MD ‡Family Voices Inc. §National Center for Family Professional Partnerships, Family Voices Inc. , Albuquerque, NM ∥Drexel University School of Public Health/College of Medicine ¶Division of General Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA.
Crystal W
CW
Cené
Beverley H
BH
Johnson
Nora
N
Wells
Beverly
B
Baker
Renee
R
Davis
Renee
R
Turchi
D006801:Humans; D010358:Patient Participation; D018802:Patient-Centered Care; D011368:Professional-Family Relations