In relatively recent times, there has been an increased recognition of the importance of patient engagement in clinical settings.¹,² Most commonly, this looks like involving the patient in making treatment decisions and looking for ways to improve compliance when it comes to managing their own care.1 The benefits reaped when a patient is actively engaged in their own care has been well-documented, and now this concept of person-centred care has become the gold standard for healthcare delivery.¹,²
A Person-Centred Approach
Focusing on the patient as a collaborator in their own care is a dramatic move away from traditional models of patient-clinician relationships. Instead of the old-fashioned way of the healthcare provider telling the patient what to do (and crossing their fingers that the patient does it), the ideal method of healthcare delivery is now a partnership.¹-³ This new dynamic is built on mutual trust and respect between the patient and, in the eyecare context, the optometrist.
Research has found that improving patient engagement comes with several advantages for both the patient and clinician. These include:¹-³
- Improved safety and quality of care
- Improved effectiveness and efficiency of the healthcare service
- Improved quality of life for the patient
- Improved patient experience and satisfaction
- Stronger trust in the patient-clinician relationship
- A more pleasant experience for the clinician
However, establishing this relationship where the patient is engaged and empowered takes some thought and effort to do well. Firstly, optometrists (and support staff, including optical dispensers), need to acknowledge that a person-centred care approach is their goal, which puts everyone in the mindset of working towards achieving this. Secondly, some training may be necessary to equip optometrists about the concept of person-centred care and patient engagement – for some, this blog article may very well be your first exposure to the idea! And thirdly, the practice must be equipped with the tools to enable patient engagement, such as resources that support patient education and communication.² Ideally, there should also be a method of measuring the success of implementing these strategies, such as monitoring any changes to healthcare outcomes or patient satisfaction.
Engaging the patient well is especially important for chronic conditions,³ such as glaucoma or age-related macular degeneration. Patients who are actively engaged are more likely to adopt practices that help their condition, rather than worsen it, such as quitting smoking. They also tend to be more compliant with medications and other treatment recommendations from their clinicians.³
Ideas for Increasing Engagement
There is no one-size-fits-all approach for increasing patient engagement in your optometry practice. A clinic that sees predominantly senior citizens in an affluent, well-educated suburb is going to have a much different experience compared to a practice serving a remote rural community, which again is going to need a different strategy compared to an optometry practice focusing on children’s vision.
As long as the optometrist concentrates on the intention to involve and engage the patient in their own care, you can’t go too far wrong! A good start is asking the patient, and where appropriate, their family or caregiver, what their preferences are. As succinctly conveyed in Krist et al, instead of “what’s the matter?” the question becomes more profound with “what matters to you?”.³
And on that note, here are some ideas to get you started.
- Provide detailed but easy-to-understand information about various conditions so the patient is empowered to make an informed decision about their treatment. This can be in the form of a pamphlet, an emailed link to a good resource online, or even a YouTube video. Whatever medium, ensure the content is accessible. That is, the patient doesn’t finish reading or watching the resource only to feel more confused and lost about what is best for them.
- Make it easy for the patient to ask questions. This could mean providing them the work email address of the optometrist, or ensuring that all phone calls are returned in a timely manner. During consultations, ensure you leave some space to encourage questions. Being available to the patient helps to build that all-important trust with the optometrist.
- Consider a feedback survey of sorts. Questions you might want to include could be along the lines of “did you feel you were given enough information about your condition and its treatment options?”, “ did you feel you had enough opportunity to ask questions during your consultation?”, “what ways can we make you feel more in control of your own care?”. And then, of course, take this feedback on board with practical steps.
- Avoid scheduling your appointments so tightly that patients feel rushed. Nothing leaves a worse taste in the mouth than having a diagnosis dumped on you, a prescription for eye drops or an ophthalmologist referral shoved in your hand, and then hurried out the door so the optometrist can take in their next patient. Granted, it takes longer to get through to some patients than others when communicating, but if you’re running on 15min appointments, you almost certainly don’t have enough time to have a meaningful conversation about management strategies for progressive myopia.
- Hold an educational evening (complete with complimentary tea, coffee, and snacks, of course) about common ocular conditions and options for management, such as cataracts. You can send out the invitation to all your patients, as it’s not just those of cataract age who may be interested, but their younger family members as well. If you extend this invitation to the local community, the session has the additional purpose of promoting your practice.
- If in a paediatric practice, run a survey to ask children how the waiting space should be decorated. Especially for children you expect to see regularly, such as those being managed for progressive myopia or amblyopia, this can make them excited to come to their appointments and put you in their very good books. Plus, why shouldn’t there be rainbows and astronauts painted on the walls!
Many optometrists are likely to already be involving patients in their own care to some degree, such as when deciding if a patient is ready for cataract surgery or happy to wait another year. However, there is always room for improvement. With a little consideration and initiative, you can increase the engagement of your eyecare patients and significantly elevate their quality of care.
- Bombard Y, Baker GR, Orlando E, et al. Engaging patients to improve quality of care: a systematic review. Implementation Sci. 2018;13:98.
- Australian Commission on Safety and Quality in Health Care. Partnering with Patients in Their Own Care. https://www.safetyandquality.gov.au/. 2023. Available at: https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard/partnering-patients-their-own-care. (Accessed October 2023).
- Krist AH, Tong ST, Aycock RA, Longo DR. Engaging Patients in Decision-Making and Behaviour Change to Promote Prevention. Stud Health Technol Inform. 2017;240:284-302.