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Patient engagement in hospital health service planning and improvement: a scoping review
  1. Laurel Liang1,
  2. Albina Cako1,
  3. Robin Urquhart2,
  4. Sharon E Straus3,
  5. Walter P Wodchis4,
  6. G. Ross Baker4,
  7. Anna R Gagliardi1
  1. 1 Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
  2. 2 Beatrice Hunter Cancer Research Institute, Dalhousie University, Halifax, UK
  3. 3 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Anna R Gagliardi; anna.gagliardi{at}


Objectives Patient engagement (PE) improves patient, organisation and health system outcomes, but most research is based on primary care. The primary purpose of this study was to describe the characteristics of published empirical research that evaluated PE in hospital health service improvement.

Design Scoping review.

Methods Five databases were searched from 2006 to September 2016. English language studies that evaluated patient or provider beliefs, participation in PE, influencing factors or impact were eligible. Screening and data extraction were done in triplicate. PE characteristics, influencing factors and impact were extracted and summarised.

Results From a total of 3939 search results, 227 studies emerged as potentially relevant; of these, 217 were not eligible, and 10 studies were included in the review. None evaluated behavioural interventions to promote or support PE. While most studies examined involvement in standing committees or projects, patient input and influence on decisions were minimal. Lack of skill and negative beliefs among providers were PE barriers. PE facilitators included careful selection and joint training of patients and providers, formalising patient roles, informal interaction to build trust, involving patients early in projects, small team size, frequent meetings, active solicitation of patient input in meetings and debriefing after meetings. Asking patients to provide insight into problems rather than solutions and deploying provider champions may enhance patient influence on hospital services.

Conclusions Given the important role of PE in improving hospital services and the paucity of research on this topic, future research should develop and evaluate behavioural interventions for PE directed at patients and providers informed by the PE barriers and facilitators identified here. Future studies should also assess the impact on various individual and organisational outcomes.

  • hospital care
  • quality improvement
  • patient engagement
  • scoping review

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors ARG envisioned and planned the study, and provided funding for research assistant support. LL, AC, RU, SES, WPW, RB and ARG established study objectives, collected and analysed or interpreted data, drafted or edited the manuscript, and read and approved the final manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are available in the manuscript or supplementary files.

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