An examination of opportunities for the active patient in improving patient safety

摘要

Background: Patients can make valuable contributions to their health care safety. Little is known, however, about the factors that could affect patient participation in safety-related aspects of their health care management. Examining and understanding how patient involvement in safety-related behaviors can be conceptualized will allow greater insight into why patients may be more willing to participate in some behaviors more than others may. Objective: This study aimed to develop a new approach for understanding and conceptualizing patient involvement in safety with specific reference to a surgical patient cohort. Methods: The authors conducted a review of the key opportunities for patient involvement along the surgical care trajectory and examination and identification of the properties and characteristics of different safety-related behaviors and the barriers to patient involvement they entail. Results: Safety-related behaviors comprise 3 main properties including the type of error the behavior is trying to prevent (e.g., medication error), the action required by the patient (e.g., asking questions), and the characteristics of the action (e.g., whether the behavior involves interacting with a health care professional). Barriers to patient involvement that relate to patients and health care professionals can be broadly categorized as interpersonal, intrapersonal, and cultural. Conclusions: We believe that thinking of patient involvement in safety relating to properties and characteristics of the behavior together with the barriers to involvement could aid the design, implementation, and evaluation of interventions aimed at encouraging patient participation. It will also enable a greater understanding and assessment of not only what interventions may be effective (at encouraging patient involvement) but when they might be effective (i.e., what stage of the care pathway) and why.