Scoping Review and Approach to Appraisal of Interventions Intended to Involve Patients in Patient Safety

Abstract

An approach for appraising interventions intended to promote patient involvement in patient safety should involve: identification of the routes by which interventions assume patients' actions might contribute to their safety; identification of the conditions that would need to be met for patients to behave and contribute as the interventions (implicitly) assume; examination of the extent to which the intervention supports fulfilment of those conditions; and consideration of the potential negative effects of the intervention.

Developing a ‘critical’ approach to patient and public involvement in patient safety in the NHS: learning lessons from other parts of the public sector?

“…Evidence, for example, shows that a Ôknowledge and status imbalanceÕ between patients and practitioners affects the ability of a patient to adopt safety-related behaviours. 24,46,47 Research by Peat and Entwistle et al 24 found that safety interventions which were most successful required patients and their representatives to be well informed and knowledgeable. This capacity was found to vary between individuals and to be significantly affected by educational level, income, cognitive skills and cultural differences, which might affect patients health beliefs and ability to utilize health services.…”

“…This capacity was found to vary between individuals and to be significantly affected by educational level, income, cognitive skills and cultural differences, which might affect patients health beliefs and ability to utilize health services. 24 In addition, Peat et al found that many patients were uncomfortable and unwilling to challenge health professionalsÕ opinions and practice. At the collective strategic level, this power imbalance was reflected in the way that patient representatives were largely expected to work within existing systems in improving quality and safety.…”

“…This was seen as problematic as it denied these individuals the space to redefine the issues and thus bring their own lay perspective Ôto the development and improvement of servicesÕ. 24 This context clearly has implications for PPI, particularly given the identification of staff support and encouragement to patients as a key factor in the development of successful involvement practice. 46 We therefore argue that adopting a more critical approach to involvement will entail going beyond current theories ⁄ models (e.g.…”

“…Firstly, there is a need for a wider and more nuanced debate about how to progress PPI in patient safety which goes beyond the mainly atheoretical nature of much of the literature on PPI in patient safety. 24 Secondly, this debate needs to recognize the contested nature of involvement and the way in which calls for greater participation across the public services have been driven by a range of disenfranchized social groups, challenging the nature of oppressive and discriminatory service provision, which has excluded them. Lastly, there is a need to consider what lessons can be learned for the development of PPI in patient safety, from this contested agenda and the development of a range of critical theories that have emerged more broadly in health and social care in the study of involvement processes.…”

Pediatric hospitalist comanagement of surgical patients: Structural, quality, and financial considerations

“…29 An important tool for addressing these needs is family-centered rounds (FCRs), which represent multidisciplinary rounds at the bedside involving families and patients as active shared decision makers in conjunction with the medical team. 30,31 Although FCRs have not been studied in comanagement arrangements specifically, evidence suggests that this tool improves family centeredness and patient safety in nonsurgical patients, 32 and FCRs can likely have a similar impact on postoperative care.…”