Grant: CIHR Clinician Scientist - Phase 2

There is a wide consensus that healthcare improvement requires strong partnerships between patients and professionals. However, little research exists on how patients and the public can effectively be involved in healthcare improvement. In a recent study, we tested an intervention to involve patients together with professionals in setting common priorities for healthcare improvement, which demonstrated that it is feasible to involve patients and the public in strategic healthcare decisions and that it can increase consensus between patients and professionals improvement priorities. The goal of this research program is to test the generalizability of this intervention in different contexts of primary healthcare improvement. We will first tailor our intervention to three important primary healthcare issues: access, chronic disease management, and end-of-life care. We will then implement our involvement intervention in 8 different sites, each addressing one of these three issues. 200 participants (including 120 patient and public representatives, and 80 professionals) will be recruited. Participants will be informed about the policy issue and available options, consulted about their preferred choices, they will deliberate together to agree on common recommendations, and these recommendations will be communicated to relevant decision-makers. We will explore the relationship of key contextual factors (community, organizations, and policy issue) with the process and outcome of involvement, using research instruments previously tested. This research program will foster the development of robust involvement interventions that are more generalizable to different policy issues, communities and organizations. This research also offers a unique opportunity to engage with patients and the public in key areas of healthcare improvement and policymaking, support health system changes that are better aligned with public needs and expectations.