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Difficult conversations? Engaging patients in reducing waste in health care

机译：对话困难？让患者减少医疗保健方面的浪费

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Purpose - Reducing waste in health care can result in savings that could be used to meet the projected shortfall in NHS funding or to meet the care needs of vulnerable groups. Patients and their families can contribute to the identification and reduction of waste. To do so their understanding of the costs of health care and treatment needs to be increased. The paper aims to discuss these issues. Design/methodology/approach - The approach formed part of the Close Partnering work stream of the NHS Future Focused Finance (FFF) programme. Included in this was a review of the literature relating to waste reduction, patient engagement and reference to experts in the field of public and patient engagement. Engagement of the patient voice in the NHS FFF programme to provide the patient perspective and engage in discussions with patients. Discussions with experts in patient and public involvement and clinicians were also undertaken. Findings - The public and patients have little awareness of NHS finances and generally perceive efforts to reduce costs and achieve efficiencies as impacting on the quality of care. Engaging the public and patients in discussions about the costs of health care is challenging and existing methodologies for patient and public engagement may not be appropriate for what could be termed difficult conversations. Social implications - Increasing patient awareness of the costs of health care and treatment may result in patients and the public demanding greater involvement in decisions about health care expenditure and use of resources. Originality/value - Difficult conversations with patients and the public about the costs of health and their role in reducing waste are rarely invited. This paper brings to the fore the issues and challenges that such discussions engender.
机译：目的-减少医疗保健方面的浪费可以节省下来，可以用来弥补预计的NHS资金短缺或满足弱势群体的护理需求。患者及其家人可以为识别和减少浪费做出贡献。为此，需要增加他们对卫生保健和治疗费用的了解。本文旨在讨论这些问题。设计/方法/方法-该方法是NHS未来聚焦财务（FFF）计划的紧密合作工作流的一部分。其中包括对与减少废物，患者参与有关的文献的回顾，并向公众和患者参与领域的专家提供了参考。参与NHS FFF计划中的患者声音，以提供患者观点并参与与患者的讨论。还与患者和公众参与的专家以及临床医生进行了讨论。调查结果-公众和患者对NHS财务状况知之甚少，并且普遍认为降低成本和提高效率的努力会影响到护理质量。让公众和患者参与有关卫生保健成本的讨论具有挑战性，而现有的患者和公众参与方法可能不适用于所谓的艰难对话。社会影响-增强患者对卫生保健和治疗成本的认识可能会导致患者和公众要求更多地参与有关卫生保健支出和资源使用的决策。原创性/价值-很少邀请患者和公众就健康成本及其在减少浪费方面的作用进行艰难的对话。本文将这种讨论所引起的问题和挑战放在首位。

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