Guiding Principles for Patient Engagement

The Nursing Alliance for Quality Care (NAQC) released Guiding Principles for Patient Engagement, a list of nine core principles designed to support nurses and other health care providers in delivering high-quality, patient-centered care. The principles, developed by a committee of nurse leaders and patient advocates, are meant to guide the provider community in developing patient engagement models and quality and safety interventions that support and encourage the patient and family to become partners in their care. The development of the principles, and the organization, is supported by the Robert Wood Johnson Foundation, the nation’s largest health care philanthropy.

The principles include:

• There must be a dynamic partnership among patients, their families, and the providers of their health care, which at the same time respects the boundaries of privacy, competent decision-making, and ethical behavior.
• This relationship is grounded in confidentiality, where the patient defines the scope of the confidentiality. Patients are the best and ultimate source of information about their health status and retain the right to make their own decisions about care.
• In this relationship, there are mutual responsibilities and accountabilities among the patient, the family, and the provider that make it effective.
• Providers must recognize that the extent to which patients and family members are able to engage or choose to engage may vary greatly based on individual circumstances. Advocacy for patients who are unable to participate fully is a fundamental nursing role.
• All encounters and transactions with the patient and family occur while respecting the boundaries that protect recipients of care as well as providers of that care.
• Patient advocacy is the demonstration of how all of the components of the relationship fit together.
• This relationship is grounded in an appreciation of patient’s rights and expands on the rights to include mutuality.
• Mutuality includes sharing of information, creation of consensus, and shared decision-making.
• Health care literacy is essential for patient, family, and provider to understand the components of patient engagement. Providers must maintain awareness of the health care literacy level of the patient and family and respond accordingly. Acknowledgment and appreciation of diverse backgrounds is an essential part of the engagement process.