SHM’s I-HOPE Stakeholder Committee has partnered with patients and other stakeholders to improve the care and experiences of hospitalized patients through creating a patient-centered research agenda and network of stakeholder collaborators. These resources can be used by patients, stakeholders, advocacy groups and researchers.
Even though millions of patients are hospitalized each year, significant gaps in care exist. These include gaps in safety, such as medication errors and hospital-associated complications, inconsistent delivery of evidence-based care and poor care transitions.
Since the Institute of Medicine Report “To Err is Human,” increased attention has been paid to improving the care of hospitalized patients. Specific improvement strategies include utilization of guidelines, pathways, checklists, and the application of quality improvement techniques to improve processes.
Despite improvements in focused areas such as prevention of hospital-acquired infections, evidence suggests that systematic improvements in outcomes of hospitalized patients have not been achieved. Rates of errors and hospital-related complications remain high, and not all patients receive the care known to be appropriate for their illnesses.
Diverse studies report that twenty 20 to thirty 30 percent of hospitalized patients experience errors in care. Finally, care transitions are recognized as a particularly vulnerable time in terms of communication failures. Despite significant attention being paid to the area of care transitions, including financial penalties for readmissions, they remain a stubborn and difficult problem.
Additionally, hospitalization can be an overwhelming experience for patients and families. There are many reasons for this: they are sick, often with symptoms whose causes may be unclear; they are cared for by many different providers with whom they do not have relationships; they experience complications, adverse events, and errors in care; and they may be discharged without clear instructions or follow-up plans for care. These issues are well-documented in the medical literature. What is less clear is where patients’ and families’ priorities lie to address them.
To better understand patients’, families’, and other stakeholders’ perspectives on the most important gaps in hospital care, the committee proposes a systematic engagement process followed by an in-person prioritization meeting that sets the stage for future research and collaboration. The need and rationale for our proposal is clear: patients’ voices must be at the forefront of this work, and to date they have been largely absent.
The inclusive, iterative approach to identification and prioritization of unanswered questions ensures that patients’ and stakeholders’ voices are clearly heard and that the in-person meeting results in an actionable list of research priorities with a robust dissemination plan. This group of patient, family, and stakeholder participants can also form the basis for a network of stakeholder collaborators for future research.
i-HOPE Steering Committee
The i-HOPE Steering Committee consists of hospitalist researchers and patient partners. It will work with our patient and stakeholder partners, as well as the Society of Hospital Medicine, to develop the research agenda. Learn more about the members in the project orientation document.