CMS rolls out strategy to engage patients and family in healthcare decisions

Doctor talking to senior patient and her husband
CMS says that including the patient and their family in the goal-setting and decision-making process leads to improved outcomes. Image: Getty/Olgachov

Patient and family engagement requires healthcare organizations to do more than obtain informed consent. It means making sure that the patient’s voice is heard in policy, program planning and shared decision-making.

So the Centers for Medicare & Medicaid Services has released a new person and family engagement strategy that it hopes will lead to better outcomes. Its goals are to encourage engagements throughout the continuum of care, enable patients to direct and self-manage their care, create an environment that allows patients and families to work in partnership with providers to develop their healthcare goals and develop meaningful tools to improve the experience and outcomes of care.

The agency said in the report (PDF) that it defines family broadly to include informal caregivers as well as primary caregivers of people who are in need of support to make informed healthcare decisions. It also referred to a “person-centered” approach instead of “patient-centered,” to emphasize that “the individual as multifaceted, not merely as the carrier of a particular symptom or illness, or ‘receiver’ of services.”

“When people feel responsible for their own health and are partners with their providers in goal-setting and decision-making, they are much more likely to achieve their healthcare goals,” writes Kate Goodrich, M.D., director of the Center for Clinical Standards and Quality at CMS, in a blog post announcing the release of the strategy.

In a summary (PDF) of the strategy, CMS said it is challenging organizations to evaluate their own programs and take action in incorporating the goals outlined in the strategy to improve how clinicians interact with patients and their families—“ultimately improving their experience and outcomes.”

To advance the goals, the strategy encourages providers to:

  • Embrace and develop community partnerships
  • Document the shared decision-making process
  • Improve access to necessary healthcare or community resources such as transportation or language access services
  • Translate patient experience surveys into multiple languages and administer them in a method that will improve response rates for populations with limited English proficiency and include questions about the availability of language services
  • Include questions pertaining to the family perspective in the patient experience surveys
  • Attend educational programs on improving person and family/caregiver experience
  • Have resources available to help people complete advance directives that align with their wishes about end-of-life treatment and care
  • Receive training on how to participate in end-of-life treatment and care discussions
  • Identify and implement best practices on person and family engagement