Perceived Patient Engagement process

The current study proceeds with the aim of presenting a scoping paper for the pre-admission education program targeting mentally ill patients in order to minimize physical and verbal aggressions depicted by these clients towards nurses due to restrictions in place at MH HDU. Proper education of patients on crucial institutional issues within the first few hours of admission plays a significant role in instilling self-management (Wong et al. 2016). There is need for clients to be acquainted with certain set organizational policies that are established to govern personal conduct. As a consequence, the present analysis establishes the processes and diagnostic equipment to be applied in consultations; provision of detailed information on the most effective ways of collecting data to inform the adopted project plan; the inter-professional team engagements and viewpoints on how their contributions will impact the project plan; as well as the inter-professional and multidisciplinary communication initiatives to be adopted in the project plan.

Perceived patient engagement is one of the most effective processes applied when fostering consultations in the mental health sector. The physical and verbal aggressions experienced by mentally ill patients towards nurses due to restrictions in place at MH HDUcan be attributed to issues such as the effects of sicknesses, inadequate patient information during admission process regarding restrictions the ties established between the patients and the institutional stakeholders and the levels of activity of these patients in managing their problems (Siembida et al., 2018). As a consequence, perceived patient engagement is a process applied among mentally ill patients wills the aim of encouraging them towards taking active roles in ensuring that they enhance their healing processes by adhering to certain set institutional restrictions (Irizarry, Dabbs, and Curran 2015). Considering the fact that clients seeking mental health services at the NSW mental health high dependency unit of Wagga wagga depict the feeling of being treated in unfair ways based on the institution’s laxity in availing educational initiatives aimed at teaching them on the organizational policy frameworks and restrictions put in place in the preadmission sage and during examinations.  The process will be of great essence in minimizing the aggressions expressed by patients towards nurses as well as the exasperations the clients are exposed to.

Perceived patient empowerment is a consultation process applied with the aim of advocating for an increase in the extents to which clients in a healthcare institution play an active role in the decision making processes of their institutions (Bright et al. 2017). According to Hardyman, Daunt and Kitchener (2015), the technique adopts societal and scientific based advancements such as consumerism, adherence to patient centered approaches, democratization and deinstitutionalization to engage patients in setting the principles meant to guide their activities. Similarly, Smith et al. (2015) explain that the process involves proper inclusion of the mentally ill patient and he physician in shared decision making concerning critical organizational and professional issues such as the procedures set as well as the treatment options put in place to meet the client’s priorities and healthcare requirements. Similarly, caregivers can minimize the aggressions experienced by their patients by availing proper and adequate information during admission process regarding restrictions put in place by their firms.

Perceived Patient Empowerment process

To empower the stakeholders on the most effective ways of minimizing the aggressions exhibited by the clients, perceived patient engagement proceeds by integrating the knowledge, skills, viewpoints and the concerns depicted by both the caregiver and the patient. Such a move is established with the aim of establishing the desired agreements on the regulatory frameworks adopted by the institution (Frank et al. 2015). According to Graffigna, Barello, Bonanomi, and Menichetti (2016),  the perceived patient engagement process adopts a three stage decision making framework that involves bidirectional exchange of information, knowledge and ideas; deliberation of the desired and set regulatory frameworks; and selection of the option that suites all stakeholders that may be affected by the decisions made. From a conceptual perspective, the process occupies an intermediate position between the conventional paternalistic framework that considered physicians as the central decision makers based on the critical roles they played in governing the healthcare encounters and the informed choice paradigm (also referred to as the model of consumerism) that left the decision making role on the side of the patients (Haywood et al. 2015). As a consequence, the perceived patient engagement process makes it a requirement that institutional stakeholders such as healthcare professionals must have a deeper understanding of each of their clients’ needs; initiate choices that are highly judicious with the aim of ensuring that the identified needs are adequately satisfied; and present the desired solutions in such a way that they are highly effective in enabling the patient to make the right judgments.

According to Bright et al. (2017), healthcare processes such as selecting the desired treatment options and setting guiding principles meet the desired levels of institutional success when patients are actively involved. Irazarry et al. (2015) reveal that such procedures do not only play a crucial role in helping clients towards fostering self-management but also enhance their understanding of the reasons behind setting these regulations. Similarly, Siemdiba et al. (2018) demystify that increased engagement of patients in decision making processes increases their levels of adherence to the treatment options availed; extents of satisfaction with the services offered by the institution; and better control of organization based incidences.  On the other hand, Wong et al. (2016) reveal that not all patients have the zeal to participate in shared decision making processes with the caregivers and opt to play a passive role. Therefore, the preferences made by patients on their ability to participate in the decision making process tend to vary with variations in aspects such as previous experiences with healthcare institutions and the nature of clinical decisions that require deliberations. Hence, medical institutions must instill proper measures of determining and accommodating the needs of their clients through accommodation of their role preferences in critical decision making processes as a way of enhancing the delivery of patient centered services.

Observing Patient Involvement in Decision Making

Observing Patient Involvement in Decision Making (OPTION) as a Tool that could be used for Consultation

Observing Patient Involvement in Decision Making (OPTION) is one of the most effective tools applied along with the perceived patient engagement process with the aim of auditing the extents to which stakeholders in the healthcare sector engage their patients in the processes of making organization-based decisions from the perspective of an observer (Couët et al. 2015). According to Hess et al. (2016), OPTION as an auditing tool was advanced on the basis of systematic reviews to focus on the effects of the behaviors put in place by healthcare providers. On the other hand, Agoritsas et al. (2015) explain that the OPTION instrument was conceived to vet the discursive subject matter of the consultations established between the caregiver and the patient while concentrating on a particular “index problem”. In the OPTION instrument, patients are considered to play the role of observers and are required the levels of expertise of the caregivers based on 12 “patient-inclusion” traits using a scale ha ranges between 0 and 4. The score obtained by an individual professional is then considered as an informative blueprint on the areas that need to be rectified when adopting and implementing a regulatory policy.

OPTION can be applied in the perceived patient engagement process by vetting the clinician’s ability to identify the existing institutional challenges; explaining equipoise; evaluate the most effective approach; list the available options that are based on the discussions established with the clients; explain the advantages and disadvantages of the options arrived at; explore the concerns put forth by each stakeholder; audit the extents to which the options chosen have been understood by each of the parties included in the discussion; availing opportunities and platforms aimed at empowering the stakeholders to present questions and possible areas of concern; elicit the desired aspects of involvement; indicate the need to take a decision; and reveal the need to defer/ review the initial decisions arrived at (Agoritsas et al. 2016).

According to Kunneman et al. (2016), proper application of OPTION makes it a requirement for the concerned practitioner to draw higher levels of attention to the identified organizational problem while prioritizing it as one that calls for inclusion of adequate decision making procedures. On the other hand, Stacey et al. (2017) stress on the need for both the physicians dealing with the patients and the institution to realize that there are multiple ways of dealing with the problem at hand. However, priority is given to the approach put forth by the client for the purpose of assessment and assistance of the decision making criteria. In this stage, Agoritsas et al. (2016) explain that the concerned parties could foster consultation based discussions, extract information from printed materials or evaluate graphical data. Therefore, OPTION is one of the most effective consultation tool based on its inherent capabilities to foster patient guided decision making and application of evidence based approaches.

Benefits of Patient Engagement in Decision Making

How Data will be collected to inform the Project Plan

One on one interview, surveys and collaborative workshop mode will be applied to foster data collection among patients seeking mental health services at the NSW mental health high dependency unit of Wagga wagga.

One-on-One Interviews

Lewis (2015) describes one-on-one interview as a primary method of collecting data in which the organizational stakeholders are interviewed to avail the data needed for the analysis. To apply one on one interviews at the NSW mental health high dependency unit of Wagga wagga, I will progress by informing concerned stakeholders such as patients, caregivers, nurses and the administration on the importance of the proposed initiative in fostering patient centered healthcare delivery, enhancing the levels of adherence to the regulatory frameworks set by the institution and reducing the prevalence rates of aggression depicted by the professionals and patients. According to Coulter, Locock, Ziebland, and Calabrese (2014), the targeted interviewees need to be presented with proper knowledge concerning the objectives of the study as a way on enhancing their degrees of focus on the interview session. Therefore, I will create a list of questions to ask the targeted stakeholders on pertinent issues such as the efficacy of the frameworks adopted by the institution to instill restrictions, possible ways of minimizing the physical and verbal aggressions experienced and the most effective and innovative techniques of adopting a preadmission education program targeting both the physicians and the patients that are based on the principles of shared decision making, empowerment and inclusivity.

Survey

A survey will be organized to foster data collection from the larger audiences exhibited by the larger audiences at the NSW mental health high dependency unit of Wagga wagga. A set of questions concerning the degrees of active engagement of patients in this facility, levels of empowerment and patient centeredness will be assessed based on the answers received from the institutional stakeholders. According to Lewis (2015), proper deployment of surveys calls for inclusion of modern technologies such as the internet. Therefore, key organizational players such as patients, medics and administrators will be sent the survey questions by the use of emails. Further, close-ended questionnaires containing an array of features from which the partakers are supposed to make choices will be adopted.

Collaborative workshop mode

Adoption of the collaborative workshop mode as a means of collecting institutional data is aimed at fostering inclusivity and participation from all organizational stakeholders (Lewis 2015). For the NSW mental health high dependency unit of Wagga wagga, three workshops will be organized to ensure that the objectives of minimizing aggressions experienced between the patients and physicians, enhancing the levels of engagement and empowerment of the patients seeking medical services in this institution and fostering collaborative decision making. According to Coulter, Locock, Ziebland, and Calabrese (2014), the collaborative workshop mode of collecting institutional data presents multiple benefits based on its inherent capability to strengthen the levels of engagement among the stakeholders, setting the desired organizational goals, expectations and objectives.

Inter-Professional Team Involvement and Perspectives

The preadmission educational initiative proceeds with the aim of enhancing the knowledge base of the practitioners at the NSW mental health high dependency unit of Wagga wagga on the importance of fostering fair treatments as a way of minimizing the levels of aggression experienced between clients and nurses as well as the frustrations faced by the service seekers to increase the quality of services delivered. Therefore, key stakeholders in this project will include emergency department nurses, psychiatrists, HDU nurses and MHECS workers. According to Liaw et al. (2014), inter-professional involvement plays a crucial role in fostering collaborations between the clients and the team of caregivers that is based on participatory, collaborative and coordinated viewpoints to shared decision making in institutional contexts. To enhance the degrees of involvement of the targeted caregivers, avenues such as workshops, corporate and departmental meetings will be adopted to ensure that all stakeholders are assembled to reveal their grievances, areas that require rectifications, possible ways of correcting initial flaws and effective ways of setting professional boundaries when dealing with patients. Further, the stakeholders will be educated on the importance of availing adequate patient information during admission process regarding restrictions by stressing on issues such as disallowing cigarette smoking in the wards, the dangers associated with wearing laced shoes and long cords on clothes.

Crucial professional and institutional perspectives will be incorporated to audit the levels of efficacy of the inter-professional teams adopted. For instance, the project will assess the degrees of applicability of pertinent characteristics of well-functioning teams such as the availability of common and shared goals, the professional’s ability to undertake tasks and responsibility that are relevant to the set organizational goals, the efficacy of team members to work with higher degrees of independence, as well as their abilities to undertake varied roles and responsibilities. According to Foronda, MacWilliams and McArthur (2016), the prerequisites of the aforementioned inter- professional perspectives include the ability of the targeted stakeholders to minimize interpersonal conflicts, building trust and safety.

The aforementioned inter-professional engagements and perspectives will be of great essence in enhancing the levels of operational effectiveness among the partakers of the educational initiative. According to Chu, Sorin-Peters, Sidani, De La Huerta and McGilton (2018), proper inclusion of institutional stakeholders strengthens key aspects of cooperation such as sharing of valuable information, proper communication, fostering inclusive decision making and addressing the problems affecting their clients based on a generalized perspective. On the other hand, Bays et al. (2014) reveal that proper inclusion of caregivers drawn from varied areas of practice plays a role in fostering their divergence from the traditional service oriented approach to a more collaborative and person centered framework. The fact that the caregivers will increase their focus on ensuring that their clients attain the desired levels of satisfaction will be of great essence in fostering the efficacy of the preadmission education program at the NSW mental health high dependency unit of Wagga wagga.

Inter-Professional and Multidisciplinary Communications Strategies

The primary inter-professional and multi-disciplinary communication strategies to be implemented in the preadmission educational initiative will include active listening, establishment of a common understanding and inclusion of negotiations. According to Chu et al. (2018), active listening in multidisciplinary settings plays a role in fostering proper inclusion of services based on qualitative and quantitative pieces of evidence. Therefore, stakeholders such as emergency department nurses, psychiatrists, HDU nurses and MHECS workers at the NSW mental health high dependency unit of Wagga wagga will be encouraged to inculcate proper ways of paying attention to  crucial issues of communication such as non-verbal communication as a  way of fostering understanding. Similarly, the stakeholders will be educated on the importance of availing adequate patient information during admission process regarding restrictions by stressing on issues such as disallowing cigarette smoking in the wards, the dangers associated with wearing laced shoes and long cords on clothes.

Conclusion

The study aimed at establishing the processes and diagnostic equipment to be applied in consultations; provision of detailed information on the most effective ways of collecting data to inform the adopted project plan; the inter-professional team engagements and viewpoints on how their contributions will impact the project plan; as well as the inter-professional and multidisciplinary communication initiatives to be adopted in the project plan. Perceived patient engagement was adopted as one of the most effective processes of fostering consultations. Observing Patient Involvement in Decision Making (OPTION) was adopted as a tool to be applied along with the perceived patient engagement process. One on one interview, surveys and collaborative workshop mode will be applied to foster data collection among patients seeking mental health services at the NSW mental health high dependency unit of Wagga wagga.

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