Evaluating Patient, Family and Public Engagement in Health Services Improvement and System Redesign.

As efforts to actively involve patients, family members and the broader public in health service improvement and system redesign have grown, increasing attention has also been paid to evaluation of their engagement in the health system. We discuss key concepts and approaches related to evaluation, drawing particular attention to different and potentially competing goals, stakeholders and epistemological entry points. Evaluation itself can be supported by an increasing number of frameworks and tools, matched to the relevant purpose and approach. The patient engagement evaluation field faces several challenges, including the need for greater specification of both the form and the context of engagement, the need to balance the measurement imperative with the relational aspects of care and the need for supportive organizations with the capacity and commitment to undertake high-quality engagement and its evaluation.