3. Selecting Domains and Items

Goal:

The goal of this module is to identify the areas or domains of impact you want to evaluate and the items you will use to do this. The logic model you created in the previous module will help guide these decisions.

What are the potential impacts of your patient, family and caregiver engagement work?

As you begin this process, refer back to the work you've done on the logic model so far. What are the expected impacts of the initiative?

The Engage with Impact Toolkit includes 33 items across 8 domains that can be used to structure your evaluation. The 8 impact domains are listed below. Each of these domains was identified through a literature review and in collaboration with our Working Group and the broader patient engagement community.

A minimum set of 8 core impacts (one per domain) were identified to be used as a starting point for evaluating impact. We strongly encourage all users to include these core measures in their evaluation. Each domain also includes a number of supplementary items. These supplementary items can be included in evaluations if you want to go further and evaluate the domain of interest in greater detail.

Each item relates to an impact at either the people (P), program (PG), organization (O) or health system (HS) level. When identifying the supplementary items you'd like to include in your evaluation, consider which level of impact you'd like to evaluate and ensure that you are picking items for that level. You may, for example, want to focus on items at the people and program level at the beginning of your evaluation. As your initiative unfolds and matures, you may then which to focus on organization and health system level impacts.

The Eight Impact Domains + Core and Supplementary Items

Domain

Core Item

Supplementary Items

Knowledge & Skills

Patient, family and caregiver partners develop new or improve existing skills as a result of their involvement in patient engagement and partnering activities (P)

Staff gain new knowledge/skills as a result of their involvement in patient, family and caregiver engagement and partnering activities (P)

Patient, family and caregiver partners increase their knowledge of the health system as a result of their involvement in patient, family and caregiver engagement and partnering activities (P)

Confidence & Trust

Patient, family and caregiver partners and staff see increased value in the results of the work (PG)

Patient, family and caregiver engagement and partnering leads to greater trust among program providers and participants (P)

Staff feel more confident in participating in patient, family and caregiver engagement and partnering activities (P)

When patient, family and caregiver partners are on the team, the work produced has greater credibility among stakeholders (PG)

Patient, family and caregiver engagement and partnering leads to increased trust in the health system (HS)

Equity & Inclusivity

Patient, family and caregiver engagement and partnering contributes to more equitable programs because they are shaped by a diversity of perspectives (PG)

Patient, family and caregiver engagement and partnering contributes to more equitable decision-making within health systems (HS)

Priorities & Decisions

Patient engagement and partnering shapes the organization’s plans/priorities/decisions/policies (O)

Patient, family and caregiver partners are involved in decision-making (PG)

Patient, family and caregiver partners influence final decisions/outcomes (PG)

Effectiveness & Efficiency

Patient, family and caregiver engagement and partnering contributes to the design of effective programs because they reflect the priorities of those who will be using the programs (PG)

Patient, family and caregiver engagement and partnering contributes to cost-effective programming across the organization (PG)

Patient, family and caregiver engagement and partnering supports the use of health care dollars in a fiscally responsible way (HS)

Patient Centredness

Patient, family and caregiver engagement and partnering makes the health system more aware of the patient journey and challenges in the system (HS)

Patient, family and caregiver engagement and partnering facilitates the ability for organizations to provide client-centred services (O)

Patient, family and caregiver engagement and partnering contributes to programming that is more patient-centred (PG)

Engaging patient, family and caregiver partners increases the relevance of the program as it reflects the needs of patients/families/caregivers (PG)

Organizations are better able to offer the right services, in the right way at the right time (O)

Culture Change

Organization adopts a culture of co-designing and co-producing health care (O)

Staff and leadership gain a greater appreciation of the importance of patient, family and caregiver engagement and partnering (P)

Staff gain a better understanding and appreciation of the issue from the patient perspective (P)

Patient, family and caregiver partners are valued by the organization (O)

Patient, family and caregiver engagement and partnering is sustained beyond the support of an organizational champion (O)

Patient partners are embedded in all programs within the organization (O)

Patient engagement and partnering becomes embedded throughout the health system (HS)

Patient, family and caregiver engagement and partnering is valued and recognized by the health system (HS)

Patient Outcomes & Experience

Patient, family and caregiver engagement and partnering contributes to improved patient outcomes (HS)

Patient, family and caregiver engagement and partnering contributes to improved patient care (HS)

Patient, family and caregiver engagement and partnering contributes to improved patient satisfaction/experience (HS)

Training Video

Key action steps and resources

Identify the domains and items of interest

Using your logic model, identify the domains and items that are of interest for your evaluation; complete the worksheet to outline these domains and items

Resources to support this step:
- Domain and Item Database