1. PATIENT PARTNERSHIP IN HEALTH CARE A NECESSARY TRANSITION
CENTRE OF EXCELLENCE ON PARTNERSHIPWITH PATIENTS AND THE PUBLIC
PATIENT PARTNERSHIP IN HEALTH CARE
A NECESSARY TRANSITION
Vincent Dumez, M.Sc., patient, co-director

2. CONFLICTS OF INTEREST
NONE TO DECLARE

3. THE EXPERTISE OF LIVING
WITH AN ILLNESS
PARTNERSHIP
CRISIS
ACTIVISM
ANALYSIS
PREVENTION
TRANSFORMATION

4. THE BIRTH OF THE MONTREAL MODEL
IT BEGAN IN 2010
SHARED VISION OF A DEAN OF A FACULTY OF MEDICINE AND AN EXPERIENCED PATIENT
CREATION OF THE PATIENT PARTNER OFFICE – FIRST IN THE WORLD
DEPLOYMENT IN MEDICAL & HEALTH SCIENCES EDUCATION WITH A SPECIFIC FOCUS ON COLLABORATION
DEPLOYMENT IN HEALTH INSTITUTIONS WITH A SPECIFIC FOCUS ON QUALITY IMPROVEMENT
DEPLOYMENT IN RESEARCH WITH A SPECIFIC FOCUS ON GOVERNANCE

5. « THE MONTREAL MODEL » AN EMERGING EXPERTISE
CO-LEAD UNIT
PARTNERING IN HEALTH EDUCATION
+ 10 education programs
PROGRAM TRANSFORMATIONS (MD-
TRAINING OF STUDENTS
MENTORING OF STUDENTS
EXPERT
PATIENTS
RESEARCHERS
HEALTH PROFESSIONALS
HEALTH MANAGERS
CENTRE OF EXCELLENCE
PARTNERING IN CARE
+ 25+ health care institutions
HEALTH CARE QUALITY IMPROVEMENT
HEALTH GOVERNANCE
PUBLIC POLICY DEVELOPMENT
PARTNERING IN RESEARCH
+10 national research networks
RESEARCH GOVERNANCE
RESEARCH CO-DESIGN
RESEARCH TRANSLATION
DEDICATED TO CO-BUILDING AND PATIENT PARTNERSHIP

6. BUILDING ON EXPERIENCES An emerging expertise…
PARTNERSHIP PATIENT:
BUILDING ON EXPERIENCES
A historical trend...
An emerging expertise…
Participatory
Research
Science
& technology
Patient Centered
Care
Self-Management
Knowledge
Translation
Shared
Decision Making

7. ONE QUESTION : A 4-PART STORY
WHY ARE PATIENTS AND FAMILIES UNAVOIDABLE PARTNERS IN CARE ?

8. NOT ONLY CUSTOMERS…
PATIENTS AND FAMILIES ARE NOT ONLY CUSTOMERS BUT ALSO PRODUCERS OF CARE 1

9. INADEQUATE CARE SETTINGS
EXPERIENCED PATIENTS
INADEQUATE CARE SETTINGS
>50%
of the population in western countries suffer from at least one chronic disease

10. PATIENTS AS ACTORS OF CARE
INFORMED DECISION MAKING
EXPERIENCE-BASED KNOWLEDGE
CARE SKILLS DEVELOPMENT
FULL MEMBER OF THE CARE TEAM
FOCUS ON LIFE PROJECT
TO THE PATIENT
FOR THE PATIENT
WITH THE PATIENT
CO-BUILDING
CO-LEADERSHIP
INFORMING
CONSULTING
INVOLVEMENT
PARTNERSHIP

11. NOT ONLY TAKEN IN CHARGE…
PATIENTS AND FAMILIES ARE NOT ONLY EXPRESSING NEEDS BUT THEY ARE ALSO OWNERS OF A RICH KNOWLEDGE 2

12. LIMITED TIME SPENT WITH PATIENTS
IN CLINICAL SETTINGS
5-10 hours
= average annual time spent by patients with chronic diseases with their health care professionals
*Engaging Patients in Healthcare by Angela Coulter

13. LOTS OF TIME SPENT BY PATIENTS AND FAMILIES IN SELF-MANAGEMENT
6000+ hours
= average annual time spent
by patients with chronic diseases
and families for their own care
*Engaging Patients in Healthcare by Angela Coulter

14. A SPECIFIC EXPERTISE: FOUNDATION OF LEGITIMACY
DISEASE
EXPERTS
EXPERTS IN LIVING WITH AN ILLNESS
SHARED VALUES
ACKNOWLEDGED COMPLEMENTARITY
HEALTH PROFESSIONALS &
RESEARCHERS
PATIENTS
CO-BUILDING & CO-LEADERSHIP

15. IMPROVEMENT USUALLY PRIORITIZED BY PATIENTS AND FAMILIES
Self-management capacity
Patient empowerment in its choices
Development of patient care skills
Negotiating treatment options depending on the patient's life project
Identification and validation of treatment options with the patient
Empathy and emotional intelligence
Integration of the patient's life context in clinical reasoning
Diagnosis announcement
EVOLUTION TOWARDS PARTNERSHIP IN CARE
FROM PATERNALISM TO PARTNERSHIP
LEVEL OF PARTNERSHIP AND PATIENT INTEGRATION IN CARE
Information to the patient and validation of his understanding of his health problems
Autonomy

16. IMPROVEMENTS ARE A MUST
50 to 70 %
of patients with chronic condition don’t properly respect their prescriptions

17. NOT ONLY USERS…
PATIENTS AND FAMILIES ARE NOT ONLY SERVICE USERS BUT ALSO EXPERIENCED PLAYERS / OBSERVERS OF OUR HEALTHCARE SYSTEMS 3

18. PATIENTS HAVE A UNIQUE AND ESSENTIAL VIEW OF THE SYSTEM
JOURNEY
VIEW
I’M HAPPY 
HOSPITALO CENTRIC VIEW
I FEEL BAD…

19. RESEARCH : A HUGE GAP BETWEEN PERSPECTIVES

20. A CULTURAL MOVEMENT ON THE RISE…
PATIENTS AND THEIR FAMILIES ARE MORE AND MORE ‘CONNECTED’ AND ARE DEVELOPING REFLEXIVE CAPACITIES THAT ARE INCREASINGLY IMPORTANT 4

21. ALREADY CONNECTED
70 %
of patients search online for health-related information before meeting their healthcare professional

22. It’s just the beginning of a trend that will transform the paradigm
ANOTHER ELEPHANT IN THE ROOM!
PRESSURE ON CLINICAL PRACTICES
It’s just the beginning of a trend
that will transform the paradigm
« Dr. Google »
Personalized
Medicine
Blogs, social media, etc.
Apple Watch
& Co.
Sophisticated
Monitoring Tools
Telehealth

23. HOW TO MOVE FORWARD ?

24. INDISPENSIBLE AGENTS OF
CHANGE AND INNOVATION
Partnership
Co-leadership
Consult
Implicate
Inform v
IN GOVERNANCE
Quality
Organization
Health Policy
Statistics
Data
Perceptions
Opinions
Experiential
Knowledge
PARTICIPATION IN CARE/CLINIC
Patient
Partners
IN RESEARCH
IN EDUCATION
Inspiré de «  At the Intersection of Health, Health Care and Policy «, Kristin L. Carman, Pam Dardess, Maureen Maurer, Shoshanna Sofaer, Karen Adams, Christine Bechtel and Jennifer Sweeny, Patient and family, Developing Interventions And Policies Health Affairs, 32, no.2 (2013):

25. IT IS TIME TO IMPLICATE PATIENTS AT THE RIGHT STAGE IN THE RIGHT WAY
ENGAGEMENT DANS LA QUALITÉ DE L’EXPÉRIENCE DE SOINS ET SERVICES :
EN AMONT
EN CONTINU
DÉCISION PARTAGÉE
CO-LEADERSHIP
CO-CONSTRUCTION
PARTENARIAT
Participation
Patients
Professionals
Consultation
Information
Confrontation
Boivin, Dumez, Gauvin, Lebel, 2015

26. TWO NECESSARY APPROACHES, ONE ESSENTIAL DISTINCTION
CO-BUILDING ENGAGEMENT
ADVOCACY REPRESENTATION
PRINCIPAL
KNOWLEDGE
EXPERIENTIAL
Significant experience of healthcare and services
SOCIO-POLITIC
Organizational and policy knowledge
LEGITIMACY
EXPERIENCE-BASED KNOWLEDGE
REPRESENTATIVE OF A COLLECTIVE OPINION
ACTION
CO-DESIGNING, CO-CREATION
POSITIONNING,
ADVOCATING, DEBATING
GOAL
IMPROVING HEALTHCARE AND SERVICES
RECOGNITION OF PATIENT RIGHTS
STRATEGY
BUILDING FROM INSIDE
INFLUENCING FROM OUTSIDE

27. MANAGING A MAJOR CULTURAL CHANGE PROCESS/ PROGRAMMATION
GOVERNANCE
DEVELOP A CULTURE OF PARTNERSHIP
STRUCTURE PATIENT ENGAGEMENT
MANAGEMENT
PROCESS/ PROGRAMMATION
DEPLOY A VISION OF
PARTNERSHIP IN HEALTH
HEALTH ORGANIZATION

28. OUR MISSION
To support the practice and science of partnership between patients, professionals and the public
AN INTERNATIONAL NETWORK
IN DEVELOPMENT

29. OUR PARTERS