Patient and Public Involvement (PPI) strategic documents are viewed as an essential feature of organisational commitment to openness and transparency. They provide a mechanism to communicate opportunities for wider community influence in healthcare. The absence of documentation can be negatively interpreted, for example during regulatory inspection, as a lack of intent by organisations to collaborate with a broad constituency. Published literature paints a confusing picture of rationale and evidence that could provide the foundation for strategic action. This makes it difficult for those responsible for turning goals into meaningful involvement. We investigated how content is presented and organised in strategic documents. This pragmatic study is intended to stimulate reflective practice, promote debate and generate further inquiry with a wide audience. We created and iterated a framework adapted from 4Pi National Involvement Standards to analyse organisational PPI strategic documents against five domains which are principles, purpose, presence, process and impact. Fifteen strategic documents were grouped into four categories (acute care providers; clinical commissioning groups; community healthcare providers; and other) and included for analysis. A matrix was produced. By reading the matrix vertically (down) and horizontally (across), comparisons can be made between 4Pi domains and across organisations. There was no discernible pattern between domains or between organisations. There was variation in the level to which criteria were met. No single strategy fully met the criteria for all five domains of 4Pi National Involvement Standards. The criteria for purpose was fully met in eight strategic documents. Only two documents fully met impact criteria. Four organisations showed better completeness with fully or partially met criteria across five domains. A single organisation partially met the criteria for all domains. The remaining 10 were unable to meet the criteria in at least one domain. Our findings align with published literature that suggests the underpinning rationale for PPI is confusing. A strategic aim is difficult to articulate. Context and complexity are at play making the sharing of generalisable knowledge elusive. We offer further critique about the value of these documents and consider: ‘is there an alternative approach to construct PPI strategy to generate theory, capture learning and evaluate effectiveness at the same time?’ We suggest testing the adoption of programme theory in PPI. The emergent nature and context sensitive features of programme theory enable curiosity, creativity and critical appraisal. It has the potential to release practitioners from the tokenistic cycle of monitoring and reporting and replace this with a richer understanding of ‘what’ works and ‘how’ tied to a ‘why’ – in order to achieve a shared aim that everyone can get behind.

中文翻译：

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患者和公众参与战略文件有多大帮助 - 使用 4Pi 国家参与标准进行框架分析的结果

患者和公众参与 (PPI) 战略文件被视为组织承诺公开和透明的基本特征。它们提供了一种机制来传达在医疗保健领域扩大社区影响力的机会。缺乏文件可能会被负面解释，例如在监管检查期间，组织缺乏与广泛支持者合作的意图。已发表的文献描绘了一幅令人困惑的理论和证据图景，这些图景可以为战略行动提供基础。这使得那些负责将目标转化为有意义的参与的人变得困难。我们研究了战略文档中内容的呈现和组织方式。这项务实的研究旨在激发反思实践，促进辩论并引发广大受众的进一步探究。我们创建并迭代了一个改编自 4Pi 国家参与标准的框架，根据原则、目的、存在、流程和影响五个领域来分析组织 PPI 战略文件。十五份战略文件分为四类（急症护理提供者、临床委托小组、社区医疗保健提供者和其他）并纳入分析。产生了矩阵。通过垂直（向下）和水平（横向）读取矩阵，可以在 4Pi 域之间和跨组织之间进行比较。领域之间或组织之间没有明显的模式。满足标准的水平存在差异。没有任何单一策略完全满足 4Pi 国家参与标准的所有五个领域的标准。八份战略文件完全满足了目的标准。只有两份文件完全符合影响标准。四个组织表现出更好的完整性，完全或部分满足五个领域的标准。单个组织部分满足所有领域的标准。其余 10 个至少在一个领域无法满足标准。我们的研究结果与已发表的文献一致，表明 PPI 的基本原理令人困惑。战略目标很难明确表达。背景和复杂性使得通用知识的共享变得难以实现。我们对这些文件的价值提出进一步的批评，并考虑：“是否有另一种方法来构建 PPI 策略，以同时产生理论、捕捉学习成果并评估有效性？” 我们建议测试 PPI 中程序理论的采用。程序理论的新兴性质和上下文敏感特征激发了好奇心、创造力和批判性评价。它有可能将从业者从监视和报告的象征性循环中解放出来，取而代之的是对“什么”有效以及“如何”与“为什么”相关的更丰富的理解——以实现每个人都可以支持的共同目标。