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Exploring the Six Stages of Patient Engagement in Healthcare

partnering with patients patient experience Sep 15, 2023

What is patient engagement?

Patient engagement refers to the active involvement of patients in their healthcare decisions, treatment plans and overall well-being. It encompasses a range of activities and behaviours that empower patients to take an active role in managing their health and healthcare. Patient engagement is seen as a key element in improving the quality of healthcare and patient outcomes.

Why is patient engagement important to improving patient experiences?

Patient experience is gaining increasing recognition in healthcare as a vital component of high-quality care delivery. A positive patient experience goes beyond clinical outcomes, encompassing the interactions, perceptions and emotions patients encounter throughout their healthcare journey. To understand and improve the elements of a patient experience, it is essential to include patients in the conversation using various tools and engagement methods: the more collaborative or empowering the communication method, the more engaged or "activated" a patient becomes.

In this context, patient engagement signifies a paradigm shift in healthcare, going beyond traditional models of care. It fundamentally shifts the approach to care: patients are not mere recipients of medical interventions but active participants in shaping their health and well-being who have unique perspectives on their health management and can embrace their role as partners in decision-making. 

The six levels of patient engagement:

At Patient Experience Agency, we have built on the work of others* to develop six levels of patient engagement, each representing a progressively increasing stage of involvement.  This evolution is underscored by the idea that the more patients are empowered and engaged in their care journey, the more profound the positive impact on their health outcomes and the broader healthcare landscape. So, let's step through the stages of patient engagement and what their implications are for healthcare.

At the core of patient experience lies the concept of patient engagement - the degree to which patients actively participate in their healthcare decisions and interact with the healthcare system. This spectrum, or levels of engagement, encompasses various increasing categories, each representing a different stage of patient involvement and empowerment.

1. Inform:  At the initial level of the spectrum, healthcare providers are informers. They provide patients with essential information about their conditions, treatment options, and care plans. Patients receive medical knowledge and instructions, but their involvement in decision-making may be limited.

2. Consult: Moving up a level, patients progress from merely being informed to becoming active participants in their care. At this stage, healthcare providers engage patients in consultative discussions, seeking their input and preferences. Patients' voices are acknowledged, but the ultimate decision-making power may remain with medical professionals.

3. Involve: As patient engagement intensifies, patients become actively involved in their care. Healthcare providers encourage patients to actively participate in shared decision-making, weighing treatment options and contributing to care planning. 

4. Collaborate: The next level is collaborative engagement, where healthcare providers and patients work together as equal partners in the care process. Patients' values, preferences and goals are fully considered and they actively collaborate in treatment decisions and planning.

5. Partner:  This extends collaboration even further by including patients in various levels of participation, from shared decision-making and information sharing to active co-design of treatment plans and healthcare policies.

6. Empower: At the pinnacle of the spectrum lies empowerment, where patients are not just passive recipients of care but actively lead their healthcare journey. Empowered patients are equipped with knowledge, skills, and confidence to make informed decisions, manage their conditions, and take charge of their overall health and well-being.

The impact of engagement on patient experience.

Patient engagement along the spectrum profoundly impacts the overall patient experience and healthcare outcomes. The level of engagement can influence various aspects, including:

  • Adherence to treatment plans
  • Greater patient satisfaction with their overall healthcare experience
  • Improved health literacy improves as patients become more engaged
  • Better communication leads to greater trust
  • Increased patient activation, which means greater self-determination, self-care and health choices.

Promoting patient empowerment and engagement to your patients.

To move patients along the spectrum towards empowerment, healthcare professionals can employ several strategies:

  • Direct patients to education about their condition, treatment plans and their ability to be involved
  • Share decision-making with your patients and engage them in the options, risks and benefits
  • Greater use of health technology, supporting self-service of health records and self-monitoring, 
  • Establish patient support programs that provide resources, coaching and encouragement along the way.

But remember that just because you are ready to engage with your patients doesn't mean your patients are at the same point in their journey as you are. It is essential to consider each patient's ability to engage actively in their own healthcare journey. Patient engagement is not a one-size-fits-all concept and patients may have varying levels of readiness, knowledge and capabilities to participate in their care decisions.

Several factors can influence a patient's ability to engage effectively, including a patient's health literacy, cultural and language considerations, physical and cognitive limitations, digital literacy, social support network and a range of psychological factors. In addition, some patients might prefer to be more passive and play a less active role.


Why health care practices should be increasing their engagement with their patients.

Understanding and moving along the spectrum of engagement, from informing to empowering patients, is fundamental to delivering exceptional patient experiences. By fostering both a culture of patient engagement and more engaged patients, healthcare professionals and practices can enhance patient satisfaction, improve health outcomes and build lasting patient-practitioner relationships. The journey towards patient empowerment is a continuous process, shaped by collaborative efforts and a patient-partnership approach to care delivery. As you prioritise patient engagement, you give agency to the value of patient experience in modern healthcare, improving outcomes and transforming lives.


Further Learning:

Ready to learn more about engaging with your patients and discover how your practice can evolve to be more PX-driven? Take our introductory Fundamentals of PX course online now.

Further Reading:

To read more about patient engagement measures in a primary practice setting, download a copy of Osana Health's Dr. Kevin Cheng's 2021 white paper "A New GP Model"

*Stakeholder Engagement Levels is a concept first organised in this way for health by IAP2 International Federation 2018 and is a foundational framework for engagement referenced in the Australian Government:  Department of Health Stakeholder Engagement Framework 2018, which can be accessed online here: 

For those engaging with Indigenous Communities, you may find these two approaches very useful:

8 Ways  8 Aboriginal Ways of Learning

Australian Facilitators Network:  Towards an Indigenous informed facilitation practice


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