A scoping review of patient engagement activities during COVID-19: More consultation, less partnership

PLoS One. 2021 Sep 29;16(9):e0257880. doi: 10.1371/journal.pone.0257880. eCollection 2021.

Abstract

Background: The COVID-19 pandemic has had a devastating impact on healthcare systems and care delivery, changing the context for patient and family engagement activities. Given the critical contribution of such activities in achieving health system quality goals, we undertook to address the question: What is known about work that has been done on patient engagement activities during the pandemic?

Objective: To examine peer-reviewed and grey literature to identify the range of patient engagement activities, broadly defined (inclusive of engagement to support clinical care to partnerships in decision-making), occurring within health systems internationally during the first six months of the COVID-19 pandemic, as well as key barriers and facilitators for sustaining patient engagement activities during the pandemic.

Methods: The following databases were searched: Medline, Embase and LitCOVID; a search for grey literature focused on the websites of professional organizations. Articles were required to be specific to COVID-19, describe patient engagement activities, involve a healthcare organization and be published from March 2020 to September 2020. Data were extracted and managed using Microsoft Excel. A content analysis of findings was conducted.

Results: Twenty-nine articles were included. Few examples of more genuine partnership with patients were identified (such as co-design and organizational level decision making); most activities related to clinical level interactions (e.g. virtual consultations, remote appointments, family visits using technology and community outreach). Technology was leveraged in almost all reported studies to interact or connect with patients and families. Five main descriptive categories were identified: (1) Engagement through Virtual Care; (2) Engagement through Other Technology; (3) Engagement for Service Improvements/ Recommendations; (4) Factors Impacting Patient Engagement; and (5) Lessons Learned though Patient Engagement.

Conclusions: Evidence of how healthcare systems and organizations stayed connected to patients and families during the pandemic was identified; the majority of activities involved direct care consultations via technology. Since this review was conducted over the first six months of the pandemic, more work is needed to unpack the spectrum of patient engagement activities, including how they may evolve over time and to explore the barriers and facilitators for sustaining activities during major disruptions like pandemics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Advertising / trends
  • COVID-19 / psychology*
  • Decision Making
  • Humans
  • Pandemics
  • Patient Participation / psychology
  • Patient Participation / statistics & numerical data
  • Patient Participation / trends*
  • SARS-CoV-2 / pathogenicity

Grants and funding

This paper was funded by the Canadian Foundation for Health Care Improvement. Dr. Kerry Kuluski holds the Dr. Mathias Gysler Research Chair in Patient and Family Centred Care at the Institute for Better Health, Trillium Health Partners. The funding for this Chair, supported by the Trillium Health Partners Foundation, was used to support Dr. Kuluski’s time in leading the study reported in this paper.