Safety first? Patient safety events from the patients' perspective: A qualitative analysis of patient experience and expert perception

Background The World Health Organization (WHO) calls for the engagement of patients to promote patient safety. Differences in the understanding of patient safety between patients and experts can make it difficult to implement measures effectively. In Germany, there is a lack of exploratory, i.e., initial and preliminary, qualitative evidence on the understanding of patient safety from the patients' perspective. Objective The aim of this study was to explore patients' understanding and experience of patient safety events. It was also of interest how healthcare experts view this patient perspective. Methods Semi-structured individual interviews were conducted with patients, their representatives, and healthcare experts (including doctors, quality management personnel, and health insurance staff). Using qualitative content analysis, the statements were analyzed exploratively, interpreted, and classified. Results A total of 34 participants (22 patients, 12 experts) were recruited. The understanding of patient safety from the patients' perspective and the experts' assessments were categorized into three activity domains: (1) medical aspects, (2) patient orientation and social interaction, and (3) care management and service quality. Domain (1) included diagnosis, treatment, hygiene, competencies, and the consequences of safety-related events. Domains (2) and (3) included communication, respect, and patient engagement, as well as coordination and access to care, system-related factors, waiting times, staff shortages, and service. Conclusion Collaborative efforts and patient safety interventions can only be successful if there is a shared understanding of patient safety. Our exploratory findings show the diversity of patient safety experiences from the patients' perspective and the different conditions that trigger their understanding of patient safety. The findings can be used to plan and implement patient safety and engagement activities.