Patient engagement resources are everywhere — but finding a tool that’s actually used by both staff and patient partners is far more rare.
A framework built together
Healthcare Excellence Canada (HEC) saw the need to make its engagement practices consistent and transparent. This led to the development of HEC’s Patient Engagement Framework, a process co-led by Patient Partners on staff at HEC. The framework was shaped in collaboration with patient partners from the HEC Patient Partner Network, interest holders from across the country and HEC staff. The framework provides clear guidance on how we engage, along with an accompanying Patient Partner Recognition Guide that aligns with the framework and was co-developed with patient partners. The framework and recognition guide have also supported other organizations across Canada in their engagement efforts.
The Framework started with a commitment: to codesign a tool that fits HEC’s context, brings our ‘fit for purpose’ approach to life, and keeps the voices of patients, caregivers and communities at the centre of everything we do.
“Engagement isn’t just about inviting patients to the table — it’s about co-creating the table together. The HEC Patient Engagement Framework reflects what’s possible when we listen deeply, design intentionally, and work in partnership with patients, families and caregivers. It’s a tool grounded in evidence and shaped by lived experience — and that’s what makes it truly fit for purpose.”
— Denise McCuaig, Executive Director, Healthcare Transformation and Capacity Building, Healthcare Excellence Canada
Shaped by real experience
Patients ultimately experience the impacts of engagement efforts, making them the best measure of a framework’s effectiveness. If a framework doesn’t work in real life practice, it isn’t useful. Ongoing input was sought from three different rounds of input from patient partners.
Patient partner, Terry Wilde, who helped codesign the framework, says the process was just as important as the final product.
“It was a wonderful experience. Everybody was included. Everybody was listened to. HEC was open to feedback, including the areas that needed to be improved,” explains Terry.
Terry highlights why it’s important to clearly set expectations up front so patient partners know how they’ll be involved.
From ‘levels’ to ‘ways’
As part of the development of the framework, patient partners reviewed the International Association for Public Participation’s (IAP2) Spectrum of Public Engagement — a common framework used before HEC created its own.
Partners raised an important point: the IAP2 Spectrum’s linear design can feel like a hierarchy, with some forms of engagement seen as less valuable. This feedback shaped HEC’s approach. The new Framework uses a circular model and talks about ‘ways’ of engaging instead of ‘levels’.
This shift reflects HEC’s belief that no single approach is better than another — all forms of engagement hold value when chosen purposefully.
Language that leads
“The words in the HEC Framework are very purposeful. I love the language that talks about leading,” remarks Sydney Graham, a caregiver and engagement specialist.
In 2023, Sydney spoke at Children’s Healthcare Canada Annual Conference. Flip the Script: High Performing Health Systems for Kids, a national conference about family engagement. Her presentation included HEC’s Patient Engagement Framework.
“Most frameworks don’t go far enough to identify that patients and caregivers can be leaders,” Sydney says. It was the word leadership in HEC’s framework that made it a stand-out for her.
“I’ve never seen any other resource talk so clearly about leadership and that’s amazing. Patients and caregivers are the experts, and organizations should be looking to them for leadership and guidance,” she firmly asserts.
Putting it into practice
Staff who work for healthcare organizations find the framework practical too. Brett Baumback is the quality improvement project lead at the Alberta College of Pharmacy (ACP). ACP is a regulatory body mandated to protect the public.
“As a healthcare organization, we exist to serve patients. When you provide real opportunities to bring patients along, you open up a whole new world that you didn't have insight into before,” Brett says.
With patient partner Melissa Sheldrick as co-chair, ACP committed to co-leading a continuous quality improvement patient working group, which provides input to a new drug error management program.
A terms of reference and best practice guide were created to support the group. Both documents referenced HEC’s Patient Engagement Framework.
“Patient engagement was new to me,” admits Brett. “It can be scary to not know where to even start. The HEC Framework simplifies engagement and helps ACP translate our needs to patient partners.”
Brett did not choose how to engage in a vacuum; the patient working group collaboratively identified their method of engagement from the framework. They landed on a hybrid style between ‘involve’ and ‘collaborate’, depending on the work they are doing.
“The framework defines not only what patients can offer us, but what ACP gives back in return so that engagement is fulfilling and meaningful.” Brett emphasizes that HEC’s framework supports mutual expectations between patient partners and staff and offers accountability for all involved.
Spreading ideas across Canada
The Provincial Health Services Authority (PHSA) in British Columbia is another organization that recognized the need to set clear expectations with patient and family partners.
Margo Dent is a family partner who works with PHSA. “I come at things from a collaborative approach,” explains Margo. “It is not us against them. Partnerships are powerful.”
Margo was involved when PHSA created their own Patient and Family Engagement Framework. Their framework is tailored for patients and families in British Columbia and draws upon HEC’s framework.
“To do good engagement, there has to be intentionality,” explains Kathryn Proudfoot, Senior Director, Patient Experience and Partnerships at PHSA.
PHSA adapted existing resources with feedback from patients, caregivers and Indigenous partners. These partners were engaged at a symposium, in focus groups and through online feedback.
“We certainly used HEC’s work, as they provide strong leadership in the space of patient engagement,” adds Kathryn.
Margo encourages other organizations to take existing resources like HEC’s Patient Engagement Framework and use them at the local level to support meaningful engagement.
“It takes more time to engage patients,” she admits, “but the return on investment is worth it.”
Terry Wilde echoes Margo’s sentiment. “The framework is a great tool for new patient partners. When I was starting in this work, I wish that other organizations would have used it, so I had a clearer idea what to expect as a partner. Healthcare Excellence Canada really is the gold standard in patient engagement in Canada,” he concludes.
More than a framework
So, when is a framework more than just a framework? When patients and staff use it to build real partnerships and trust. The HEC Patient Engagement Framework is ready for you — use it as it is or adapt it to your needs. Together, we can build stronger relationships and create bigger impact.
Ready to strengthen your engagement practices?
- Explore the Patient Engagement Framework
- Join the Patient Partner Network
