Patient involvement in safety

Project summary

Background

Approximately 10% of hospital inpatients experience adverse events due to their medical treatment. Patients themselves could help to reduce rates of adverse events by actively participating in their healthcare. At most stages of the care pathway there are opportunities for patients to contribute to their healthcare safety, including, for example, accurate provision of diagnostic information, involvement in treatment decisions, choice of healthcare provider, and the management and the monitoring of adverse events.

In recent years a number of healthcare and patient safety organisations and coalitions (in the UK and elsewhere) have introduced a variety of patient-focussed initiatives aimed at facilitating patient involvement in safety by encouraging patients to ‘Speak up’ and ask healthcare staff questions if they have any concerns about their healthcare management. However, whilst such initiatives are well intentioned, there is a paucity of empirical research on their acceptability of these initiatives from the patients’ perspective and the extent to which patients would want to take on such an active role.

Our research on patient participation in patient safety aims to address this gap in the literature through a series of research projects. The overarching aims are (i) to investigate to what extent patients are able and willing to participate in patient safety and (ii) to assess the efficacy of patients’ involvement in safety in reducing medical errors/adverse events.

This project comprises a number of elements, as follows:

1. Patients’ willingness to participate in safety-related behaviours. This project investigates patients’ willingness to participate in a variety of safety-related behaviours recommended by current patient involvement in safety initiatives (e.g. asking healthcare if they have washed their hands, notifying staff if an error occurs in their care, checking they have been given the correct medication). Specific aims of the project are to investigate patients’ baseline willingness to participate in safety-related behaviours, to delineate factors that could influence patient involvement, and to investigate the extent to which healthcare professionals could help to encourage patient participation in safety-related behaviours.
2. Patient involvement in safety: the healthcare professionals’ perspective. Given that patient involvement in safety is partly a function of what patients do in relation to their healthcare but also largely to do with their interactions with healthcare professionals it is important that both patients and healthcare professionals hold similar values and beliefs on patient participation in safety. Both need to recognise the benefits of such involvement and healthcare professionals need to encourage such activity from the patient so that the patient feels able and willing to speak up and voice any questions or concerns they may have. Therefore in order for patients to be effectively engaged, the views of healthcare professionals also need to be taken into consideration. This research strand investigates this from two angles: the extent to which healthcare professionals would be willing to support patient involvement in safety-related behaviours, and the extent to which healthcare professionals, if they were a patient themselves, would be willing to participate in safety-related behaviours
3. The role of social cognition models in predicting patient involvement in safety. A number of social cognition models (e.g. the Health Belief Model and the Theory of Planned Behaviour) have been developed to help explain why individuals may (or not) participate in various health-related behaviours. These models have been used extensively within health research to gain a deeper understanding of patients’ uptake (or lack thereof) of a variety of behaviours (e.g. smoking cessation, screening behaviours, medication compliance, alcohol use). The extent however to which such models can be used to predict patient involvement in safety-related behaviours has received very little attention. This project has taken initial steps to addressing this gap in the literature. Facilitating patient involvement in safety: what are the most effective strategies to encourage involvement? At present it is not clear what the most effective strategy is to communicate with patients to encourage them to participate in their healthcare safety. Are leaflets best? Or would a video be the most appropriate medium? Or perhaps a multi-method approach? The present research strand aims to compare patients’ views on the different mediums of communicating safety-related information and to explore what strategy patients think is most effective, and whether a single or multi-method approach to engage patients should be used.

Outputs

Selected publications (PDF)  [Needs moving to t4]