Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences

Entwistle, Vikki; McCaughan, Dorothy; Watt, Ian; Birks, Yvonne; Hall, Jill; Peat, Maggie; Williams, Brian; Wright, John

doi:10.1136/qshc.2009.039743

Cited by 98 publications

(154 citation statements)

References 19 publications

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“…Ledere anses for at vaere i en position, hvor de kan sikre de rammer, der understøtter de sundhedsprofessionelle og patienterne i at påtage sig de (nye) roller som henholdsvis facilitator og aktiv patient (Entwistle et al 2010;Mendick et al 2010;Anderson 2005Anderson , 2010, følge op med gentaenkning af arbejdsorganisering (Rangachari et al 2011;Mendick et al 2010Mendick et al , 2011, ressourceallokering og problemløsning (Wagner et al 2001) og eventuelle efteruddannelsestilbud til personalet (Navne, Nielsen & Jacobsen 2011). I den empiriske undersøgelse af ledelse af brugerinddragelse, som vi gennemførte i 2012-2013, ses ledelsen som havende en vigtig rolle som dem, der saetter mål for brugerinddragelse, definerer brugerinddragelse som en arbejdsopgave, skaber de nødvendige rammer, herunder for kompetenceudvikling og selv går foran som rollemodeller (Holm-Petersen & Navne 2013).…”

Section: Indledningunclassified

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Hvad er ledelse af brugerinddragelse? En gennemgang af mål og tre individuelle brugerinddragelsesmodeller

Holm-Petersen¹,

Navne²

2015

TFSS

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Brugerinddragelse i det danske sundhedsvæsen står højt på den politiske dagsorden, men det er stadig en udfordring at implementere visionen i klinisk praksis. Ledelse af brugerinddragelse bliver aktuelt udpeget som en central nøgle til at føre visionen ud i livet. Samtidig er der kun relativt lidt forskning om ledelse af brugerinddragelse i sundhedsvæsenet og på det empiriske plan er det uklart, hvad det er lederne skal implementere. Artiklen identificerer syv forskellige italesatte mål med brugerinddragelse, hvoraf nogle potentielt kan være i konflikt med hinanden. Herudover peges der på, at brugerinddragelse skal implementeres i en verden, hvor der allerede er en række andre mål tilstede. En central ledelsesudfordring er derfor, at nogle af målene med brugerinddragelse forudsætter nye måder at organisere ikke bare arbejdet og kompetencer på, men også relationer til patienter og pårørende. En væsentlig opgave i ledelse af brugerinddragelse vil derfor være at fremme en gentænkning af de etablerede roller og identiteter i sundhedsvæsenet. Artiklen opstiller tre forskellige inddragelsesmodeller, der hver organiserer relationer mellem sundhedsprofessionelle og sundhedsvæsenets brugere på forskellige måder.Artiklen bygger dels på en gennemgang af dansk og international litteratur og policy dokumenter, dels på en empirisk best practice undersøgelse af ledelse af brugerinddragelse, som i perioden 2012-2013 blev gennemført på tre danske hospitalsafdelinger.

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Section: Indledningunclassified

“…Den professionelles opgave består blandt andet i at vurdere, hvad patientens behov er for beslutningsstøtte for at kunne traeffe en beslutning. Dette sker gennem dialog og spørgsmål til patientens vaerdier, liv og praeferencer (Entwistle et al 2011;Entwistle et al 2010). …”

Section: Mål Med Brugerinddragelseunclassified

Hvad er ledelse af brugerinddragelse? En gennemgang af mål og tre individuelle brugerinddragelsesmodeller

Holm-Petersen¹,

Navne²

2015

TFSS

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“…There is an increasing drive to involve patients in safety initiatives (Davis et al 2007;Peat et al 2009;Entwistle et al 2010;Hall et al 2010). However, recent reviews of the literature have highlighted gaps in our knowledge about the nature and impact of patient involvement.…”

Section: Introductionmentioning

confidence: 99%

Patient-led training on patient safety: A pilot study to test the feasibility and acceptability of an educational intervention

et al. 2013

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Background: Training in patient safety is an important element of medical education. Most educational interventions on patient safety training adopt a 'health-professional lens' with limited consideration on the impact of safety lapses on the patient and their families and little or no involvement of patients in the design or delivery of the training. Aims: This paper describes a pilot study to test the feasibility and acceptability of implementing a patient-led educational intervention to facilitate safety training amongst newly qualified doctors. Method: Patients and/or carers who had experienced harm during their care shared narratives of their stories with trainees; this was followed by a focused discussion on patient safety issues exploring the causes and consequences of safety incidents and lessons to be learned from these. Results: The intervention, which will be further tested in an NIHR-funded randomised controlled trial (RCT), was successfully implemented into an existing training programme and found acceptance amongst the patients and trainees. Conclusion: The pilot study proved to be a useful step in refining the intervention for the RCT including identifying appropriate outcome measures and highlighting organisational issues.

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“…And as John Davis points out, Sen's capabilities approach in particular "gives emphasis to the idea that people are agents of their own capability development" (Davis 2013). We have been concerned previously to highlight the ways that features of healthcare provision sometimes fail to give practical support for the implementation of policies that advocate more active contributions by patients to their safety and to decision-making about their care because they impair patients' capabilities to contribute (Entwistle et al 2010a(Entwistle et al , 2010b. Hrisos and Thomson's observation raises questions about both the relationships between person-al capabilities and other (perhaps overlapping) capabilities relating to participation in healthcare.…”

Section: Patients' Recognition and Cultivation Of Their Own (And Othementioning

confidence: 99%

A Capabilities Approach to Person-Centered Care: Response to Open Peer Commentaries on “Treating Patients as Persons: A Capabilities Approach to Support Delivery of Person-Centered Care”

Entwistle

Watt

2013

The American Journal of Bioethics

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This is an electronic version of an article published in American JournalOur suggestion that the aspects of healthcare quality associated with 'person-centered care' can be understood as a matter of health services and staff recognising and cultivating a subset of capabilities that we called 'person-al'(Entwistle and Watt 2013) attracted a diverse set of open peer commentaries. Taken together, we think these commentaries highlight the strong potential of the guiding idea to illuminate and help address a range of issues of ethical concern across diverse healthcare domains. They also offer some helpful suggestions for the further development and investigation of applications of capabilities thinking in relation to person-centered care and healthcare delivery more generally.Several commentaries identify specific concerns about, and challenges for, our approach. Some of the concerns rely on interpretations of our position that we do not share. They prompt us to try to clarify some key points before responding briefly to some of the suggestions about additional implications and applications.

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Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences

Abstract: The potential for patients to contribute to their safety by speaking up about their concerns depends heavily on the quality of patient-professional interactions and relationships.

Cited by 98 publications

References 19 publications

Hvad er ledelse af brugerinddragelse? En gennemgang af mål og tre individuelle brugerinddragelsesmodeller

Hvad er ledelse af brugerinddragelse? En gennemgang af mål og tre individuelle brugerinddragelsesmodeller

Patient-led training on patient safety: A pilot study to test the feasibility and acceptability of an educational intervention

A Capabilities Approach to Person-Centered Care: Response to Open Peer Commentaries on “Treating Patients as Persons: A Capabilities Approach to Support Delivery of Person-Centered Care”

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