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Closing the Loop

What is Closing the Loop?

Closing the loop (CTL) is a key step of patient engagement. It should happen when an engagement opportunity ends or when a patient partner’s term or involvement in an engagement concludes. It involves the health care partner(s) that led the engagement communicating 3 key things:

  1. Appreciation. Acknowledge the end of the engagement and thank patient partners for their participation.
  2. Engagement Outcome/Impact. Share how the contribution of patient partners influenced the initiative.  
  3. Initiative Outcome/Impact. Share if the initiative met its aim. Share outcomes, impacts or progress made to date. 

Note: It is good practice to share progress and communicate impact with patient partners on an ongoing basis, not only at the end of an engagement.

Why is Closing the Loop Important?

Respect and Appreciation for Patient Partners
Patient partners volunteer their time, energy and experiences to health system initiatives. Their motivation often comes from wanting to contribute to positive change and improvements. Knowing how their input has influenced positive change is often what patient partners hope for in return. 

Reflection and Growth for Health Care Partners.
Taking the time to thoughtfully reflect on an engagement, and close the loop with patient partners, can also provide health care partners with the opportunity to learn and grow from acknowledging what went well and what might be improved in future engagements.

Dual Purpose Documentation
In addition to patient partners, your team or organization may also be interested in or request a written record of engagement activity and outcomes to share with others who may be interested in it, such as Accreditation Canada.

Accountability and Transparency.
Communicating to patient partners how, where and when their feedback was used is a core value of public participation. It is particularly important when engaging with Indigenous (First Nations, Inuit and Métis) people. Historically, colonial systems have conducted research, taken and used information in ways not always beneficial to or respectful of Indigenous people.  

What are PVN’s Expectations for Closing the Loop?

Health care partners who engage through PVN are asked to Close the Loop with patient partners at the end of the engagement. How that is achieved is at the discretion of the health care partners. If feasible, it is a good practice to ask patient partners how CTL would be most meaningful for them. Some options include:

  • A meeting or phone call
  • A letter or email
  • A documented engagement summary, like the PVN CTL Template.

When CTL has occurred, health care partners are asked to notify their Engagement Leader.

When should Closing the Loop take place?

We strongly suggest that Closing the Loop occurs within 3 months of the engagement ending.

Sometimes engagement opportunities end long before the initiatives do. It may or may not be possible to share back the final outcomes or impacts of an initiative within 3 months. In those situations, it is important to communicate those constraints and timelines to patient partners. As noted below, there are still things that health care partners can do to Close the Loop in the short term.  

It is good practice to:

  • Express thanks right away. Send a thank you note/email immediately after an engagement ends. Let the patient partner(s) know when they can expect a “Closing the Loop” update from you.
  • Send a prompt “What We Heard” summary. Consider sending patient partners a summary of what you learned/heard from their participation. I.e., survey results, focus group notes, key concerns/ideas raised, etc. Doing so creates the opportunity for patient partners to validate what you’ve heard. It also demonstrates that you’ve been listening and are actively reflecting on their feedback.  
  •  “Close the Loop” within 3 Months. Provide a closing the loop communication within 3 months of an engagement ending, even if that means a fulsome summary of initiative outcomes and impacts cannot be included. It’s preferable to provide prompt closure than to leave patient partners wondering what has happened. 

Please note: The onus of responsibility to determine a timeline and strategy to report back on longer term initiative outcomes/impacts lies with health care partners. PVN does not provide a mechanism or reminders for long term outcome reporting and updates back to patient partners. However, health care partners are encouraged to do so if substantial or exciting updates become available at a later date.

How does PVN support Closing the Loop?

  1. Reminders. At the end of an engagement, Engagement Leaders will contact the health care partner to ask if CTL has been completed and/or if support is required.  
  2. Facilitated Meetings. Engagement Leaders are available to facilitate an engagement close-out meeting, just ask!
  3. Closing The Loop Template. A CTL template has been created as communication tool, for use by health care partners. It could be used when an engagement concludes or when a patient partner completes their term or resigns from the engagement.

Please note:

  • The intended recipients of the CTL template are the patient partners involved. If you use it, please send it directly to them.
  • Whether or not the CTL template is completed and shared with back patient partners, the questions on it may serve as helpful prompts for discussion in a CTL meeting.

I’ve Closed the Loop – Now What?

  1. Make sure that any outstanding expenses have been reimbursed to the patient partners.
  2. Let your Engagement Leader know that CTL has been completed. If you used the CTL template, send them a copy!
  3. When the Engagement Leader receives confirmation that CTL has taken place, or after 3 months of the completion date (whichever comes first), they will distribute “End of Engagement” surveys to both the health care partner(s) who led the engagement and the patient partners who participated.

Supporting Documents

CTL Template

CTL Template – Example

CTL Engagement Notes Template

Top 10 Tips for Closing the Loop

From Our Community

Karla Warkotsch

Patient Experience Consultant – Interior Health

Karla Warkotsch

The question I like to ask health care employees is ‘Who is this for?’ and ‘Do we have the right people at the table?’ As a health care employee, I see how easy it is to fall into doing for, rather than doing with patients. The voices of the patient, family and caregiver are essential to ensure the patient is central to the direction and focus of the work being done.