A 5-facet framework to describe patient engagement in patient safety

Background: Health care remains unacceptably error prone. Recently, efforts to address this problem have included the patient and their family as partners with providers in harm prevention. Policymakers and clinicians have created patient safety strategies to encourage patient engagement, yet they have typically not included patient perspectives in their development or been comprehensively evaluated. We do not have a good understanding of "if" and "how" patients want involvement in patient safety during clinical interactions. Objective: The objective of this study was to gain insight into patients' perspectives about their knowledge, comfort level and behaviours in promoting their safety while receiving health care in hospital. Methods: The study design was a descriptive, exploratory qualitative approach to inductively examine how adult patients in a community hospital describe health-care safety and see their role in preventing error. Results: The findings, which included participation of 30 patients and four family members, indicate that although there are shared themes that influence a patient's engagement in safety, beliefs about involvement and actions taken are varied. Five conceptual themes emerged from their narratives: Personal Capacity, Experiential Knowledge, Personal Character, Relationships and Meaning of Safety. Discussion: These results will be used to develop and test a pragmatic, accessible tool to enable providers a way to collaborate with patients for determining their personal level and type of safety involvement. Conclusion: The most ethical and responsible approach to health-care safety is to consider every potential way for improvement. This study provides fundamental insights into the complexity of patient engagement in safety.