Clinicians'Perspectives of Patient Engagement in Post-Acute Care: A Social Ecological Approach

Aims: To identify rehabilitation providers'perspectives on barriers and facilitators of patient engagement in hip fracture patients in skilled nursing facilities (SNFs) within the social ecological model. Methods: We conducted 13 focus groups in SNFs throughout Los Angeles County comprised of rehabilitation staff (n = 99). Focus groups were audio-recorded and transcribed. A secondary analysis of themes related to patient engagementwere identified and organized within the social ecological model. Results: Clinicians identified barriers and facilitators of patient engagement across all levels of the social ecological model: public policy (e.g., insurance), organizational (e.g., facility culture), interpersonal (e.g., clinicians fostering self-reflection), and intrapersonal (e.g., patients' anxiety). Conclusions: Examining barriers and facilitators to patient engagement has highlighted areas which need to be sustained and improved. Thus, these findings will inform future efforts to enhance patient engagement in order can to optimize patient healthcare decisions.