Involvement of patients in patient safety must take into account that despite stated openness to the idea of involvement, patients and health professionals may not in practice show immediate concern. Lack of systematic involvement can also be attributed to limited knowledge about how to implement involvement beyond the focus of self-monitoring and compliance and a concern about the consequences of patient involvement for treatment outcomes. To realise the potential of patients' and health professionals' shared openness towards involvement, there is a need for more active facilitation and concrete guidance on how involvement can be practiced by both parties.
Patients with cancer are at risk of injury from cancer treatment procedures and as a consequence of problems related to administrative processes and communication. Types of identified events varied according to the methods used, and each method added new information. Further research on patient safety in cancer care and safety-enhancing activities is needed.
Objective
We aimed to explore whether cancer patients urgently referred to a cancer patient pathway (CPP) (CPP referred) by a general practitioner report experiences of pre‐diagnosis cancer care differently than patients not referred to a CPP (non‐CPP referred).
Methods
Data were collected from cross‐sectional questionnaire surveys among cancer patients and their GPs and linked to National registries. Poisson regression was used to generate adjusted prevalence ratios (PR) to compare reported experiences.
Results
The study included 2,256 individuals. CPP referred patients reported more positive overall experiences of the pre‐diagnosis phase (p < 0.001). Overall, CPP referred patients were 21% more likely than non‐CPP referred patients to report a positive experience after adjustment for case‐mix, comorbidity, disposable household income and educational level (PR = 1.21 [95% CI: 1.11–1.30]). The difference decreased to 14% when adjusted for Quality Deviations (PR = 1.14 [95% CI: 1.06–1.23]) and to 11% when adjusted for diagnostic interval (PR = 1.11 [95% CI: 1.02–1.20]).
Conclusion
Our findings suggest that CPP referred cancer patients have better experiences of pre‐diagnosis cancer care compared to non‐CPP referred patients. A substantial part of the difference could be attributed to shorter diagnostic intervals and/or the absence of quality deviations among CPP patients, which reveals the potential for generally improving cancer patients’ experiences by seamless and optimised diagnostic pathways.
The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quan using systematic text analysis. Study participants included registered between May 1st and August 31st 2010 care received by general practitioners, specialist 10-25% of patients experienced error during diagnosis or treat consequences. Unexpected surgical errors/complications (27%), delay due to doctors' assessment errors (24%) and unavailable test results (21%) were the most frequent types of errors identified using closed questions. 819 qua responses supplemented this information and revealed errors related to cancer detection, planning & coordination, patient-provider communication, administrative processes and treatment & medication. Physical, psychological, social as well as organizational consequences of the errors were uncovered. related to informed consent, diagnostic reasoning as well as handling of test results, referrals and the medical chart should be further improved. In addition, safety aspects of the patient patients as an extra safety barrier merit further study.
Objectives:
To identify risks associated with delivery of treatment with oral antineoplastic agents in an outpatient setting and to evaluate additional value and feasibility of engaging patients in a proactive risk analysis.
Methods:
We conducted 2 separate but parallel failure mode and effects analyses (FMEAs) among patients and health care professionals (HCPs) at a clinical oncology department in Denmark. Comparative analyses were performed using the FMEA process maps and risk priority numbers (RPNs) as main outcome measures. The FMEAs were augmented by semistructured interviews with HCPs and patients on acceptability and feasibility of FMEAs analyzed using systematic text condensation.
Results:
Patients and HCPs found failures in information regarding treatment (cause, aim, and plan) to be of high risk. Also, HCPs found failures in checking for potential interactions to be of high risk. HCPs focused on the in-hospitals procedures, whereas patients identified risks related to both the hospital and the home setting. Both HCPs and patients found participation in the FMEA process meaningful but found the use of RPNs difficult.
Conclusions:
Patient engagement in proactive risk analysis using FMEA is acceptable, meaningful, and feasible, with patients providing a different perspective on the risks associated with oral antineoplastic treatment compared with HCPs.
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