title: Promoting Patient and Family Partnerships in Ambulatory Care Improvement: A Narrative Review and Focus Group Findings.
abstract: Ambulatory practices that actively partner with patients and families in quality improvement (QI) report benefits such as better patient/family interactions with physicians and staff, and patient empowerment. However, creating effective patient/family partnerships for ambulatory care improvement is not yet routine. The objective of this paper is to provide practices with concrete evidence about meaningfully involving patients and families in QI activities.
  
  
  
  Review of literature published from 2000-2015 and a focus group conducted in 2014 with practice advisors.
  
  
  
  Thirty articles discussed 26 studies or examples of patient/family partnerships in ambulatory care QI. Patient and family partnership mechanisms included QI committees and advisory councils. Facilitators included process transparency, mechanisms for acting on patient/family input, and compensation. Challenges for practices included uncertainty about how best to involve patients and families in QI. Several studies found that patient/family partnership was a catalyst for improvement and reported that partnerships resulted in process improvements. Focus group results were concordant.
  
  
  
  This paper describes emergent mechanisms and processes that ambulatory care practices use to partner with patients and families in QI including outcomes, facilitators, and challenges.
  
  
  
  Gordon and Betty Moore Foundation.
authors.affiliation: Group Health Research Institute, Seattle, WA, USA. karinjohnso@gmail.com.
authors.forename: Karin E
authors.initials: KE
authors.lastname: Johnson
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Tracy M
authors.initials: TM
authors.lastname: Mroz
authors.affiliation: Institute for Patient- and Family-Centered Care, Bethesda, MD, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Abraham
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Marlaine
authors.initials: M
authors.lastname: Figueroa Gray
authors.affiliation: Institute for Patient- and Family-Centered Care, Bethesda, MD, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Minniti
authors.affiliation: American College of Physicians, Philadelphia, PA, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Nickel
authors.affiliation: Trillium Health Partners, Mississauga, ON, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Reid
authors.affiliation: National Partnership for Women and Families, Washington, DC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sweeney
authors.affiliation: PAMF Research Institute, Palo Alto, CA, USA.
authors.forename: Dominick L
authors.initials: DL
authors.lastname: Frosch
authors.affiliation: National Partnership for Women and Families, Washington, DC, USA.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Ness
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration* / Q000592:standards; D005190:Family; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods*; D010361:Patients; D011368:Professional-Family Relations; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards
keywords: Ambulatory care; Family engagement; Partnership; Patient engagement; Practice advisors; Quality improvement