Section 5: Activating Advocates

Research

Community Quality Collaboratives have identified eight areas in which they are engaging, to varying degrees:

  1. Collaborative Leadership & Sustainability
  2. Public At-large Engagement
  3. Quality & Efficiency Measurement
  4. Public Reporting
  5. Provider Incentives
  6. Consumer Incentives
  7. Capacity for Improving Quality
  8. Health Information Technology (HIT)/Health Information Exchange (HIE)

Not all Community Quality Collaboratives are engaged in work in every focus area, and not all stakeholders are involved in every Community Quality Collaborative focus area.

Once the advocates are sufficiently engaged and comfortable with the work at hand, Community Quality Collaborative leaders can “activate” the advocates by helping them determine what aspects of your Community Quality Collaborative's work are the best fit for them. Some advocates will be suited to participating in a leadership role. Other advocates will make a significant contribution to your Community Quality Collaborative by articulating the needs and concerns of consumers in decisions about public engagement, quality measures, public reporting, consumer incentives, and quality improvement priorities. For example, advocates can help you understand the best ways to engage the public on health care quality issues using their experiences working on other public health and public education campaigns. They also can provide input on the best way to publicly report performance measures to ensure that the information is accessible to consumers and may even help identify individuals to test messages. The advocates also may have suggestions on what kinds of incentives will result in sustained behavior changes among consumers. Many advocates also will play a major role in communicating with consumers about the goals and programs of your Community Quality Collaborative, and help to engage patients and consumers in quality issues. 

Supporting Activated Advocates

Community Quality Collaborative leaders can take several steps in the early stages to help ensure that the consumer advocates function effectively as participants in your Community Quality Collaborative.

  • Recognize that the advocates, like any new stakeholder, are likely to feel like the “odd person out” among Community Quality Collaborative participants. You can help diminish that feeling by avoiding jargon and explaining acronyms clearly every time they are used.
  • Make sure that the advocates are seen as equal partners by helping other participants understand what the advocates bring to the table, particularly with respect to their ability to reach out to the public. You also can foster mutual understanding by communicating the advocates' concerns to others in the group, briefing the advocates in advance of meetings, and making time on meeting agendas for the consumer's viewpoint so that the advocates have an opportunity to be heard.
  • Link advocates to the activities of your Community Quality Collaborative as soon as possible. While they may still be getting up to speed on the intricacies of the health care quality issue, getting involved will help them move up the learning curve more quickly; it also will ensure that you incorporate the consumer's perspective from the outset.
  • Incorporate advocates into planning and decision-making. Their role should not be limited to communicating with consumers about goals and activities, particularly ones they had no voice in developing.
  • Develop a Community Quality Collaborative structure that supports consumer advocates. There are several potential options: 1.) Consider creating a consumer engagement committee that meets independently of the other Community Quality Collaborative initiatives to help advocates with limited time and resources participate in the Community Quality Collaborative work. If you do form a consumer engagement committee, be certain to integrate the work of the committee into the overall Community Quality Collaborative efforts and vice versa. 2.) Include at least one consumer advocate in each Community Quality Collaborative workgroup. 3.) Support the advocates in forming their own quality-oriented network, from the patient perspective, to learn from each other and possibly expand upon your Community Quality Collaborative's efforts. A network like this also can help to educate other advocates not involved in the Community Quality Collaborative, creating a pool of potential participants to draw upon in the future.
  • Look for opportunities to involve the advocates in “small successes” (i.e., short-term projects that are highly likely to succeed). Some advocates may be unclear about the Community Quality Collaborative's goals and their role; a project focusing on a topic they can relate to, such as improving patient safety, can help them understand what your Community Quality Collaborative aims to do and how they can help. A “small success” also can address any skepticism they may have regarding your Community Quality Collaborative's ability to make an impact in the community.

Moving Forward

As your Community Quality Collaborative matures, consumer advocates will have many opportunities to shape your Community Quality Collaborative in a way that benefits the public-which is the ultimate goal of this initiative. To sustain them in this critical role:

  • Offer ongoing encouragement and support. For example, you can assist the advocates in being better informed and connected by distributing relevant articles about quality improvement and reporting as well as news of similar activities in other communities. Be sure to check in with the advocates on a regular basis to ask how you could make the process work better for them.
  • Continue to cultivate your relationship with the advocates. Talk to them about their role in your Community Quality Collaborative and whether they believe their involvement is making a positive impact; if not, discuss how their role could change to ensure that they are involved effectively.
  • Encourage consumer advocates to reach out to advocates in other Community Quality Collaboratives. The Community Quality Collaborative Learning Network Web site includes a membership feature to facilitate this networking.
  • Finally, anticipate turnover. In some cases, their organization's priorities may shift over time, making their continued participation infeasible or inappropriate.

Or, the individual advocates may need to leave your Community Quality Collaborative because they no longer represent the consumer organization. If this happens, be sure to ask the person who is leaving for recommendations; replacing the departing advocate with someone else in their organization can make the transition easier for everyone. If that is not possible, go back to the network of advocates you developed in the early stages and ask the other advocates participating in your Community Quality Collaborative for recommendations as well.

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Current as of November 2008
Internet Citation: Section 5: Activating Advocates. November 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/caguide/caguide5.html