What attributes of patients affect their involvement in safety? A key opinion leaders’ perspective

Abstract

ObjectiveLittle is known about which attributes the patients need when they wish to maximise their capability to partner safely in healthcare. We aimed to identify these attributes from the perspective of key opinion leaders.DesignDelphi study involving indirect group interaction through a structured two-round survey.SettingInternational electronic survey.Participants11 (65%) of the 17 invited internationally recognised experts on patient safety completed the study.Outcome measures50 patient attributes were rated by the Delphi panel for their ability to contribute maximally to safe health care.ResultsThe panellists agreed that 13 attributes are important for patients who want to maximise the role of safe partners. These domains relate to: autonomy, awareness, conscientiousness, knowledge, rationality, responsiveness and vigilance; for example, important attributes of autonomy include the ability to speak up, freedom to act and ability to act independently. Spanning seven domains, the attributes emphasise intellectual attributes and, to a lesser extent, moral attributes.ConclusionsWhereas current safety discourses emphasise attributes of professionals, this study identified the patient attributes which key opinion leaders believe can maximise the capability of patients to partner safely in healthcare. Further research is needed that asks patients about the attributes they believe are most important.

Patients' perspectives on the role of their complaints in the regulatory process

“…Sharpe and Faden have already argued that current patient safety evaluations tend ‘to reflect a narrowly clinical interpretation of harm that excludes non‐clinical or non‐disease‐specific outcomes that the patient may consider harmful’. As seen in other studies, these results stress the importance of recognizing that lay people have their own interpretations of patient safety that may conflict with current evaluation methods.…”

Parents' Perspectives on “Keeping Their Children Safe” in the Hospital

“…24,26 The degree of this vigilance and associated behaviors in parent participation varies on the basis of degree of parent autonomy, self-efficacy, and technical knowledge required. 13,20,25,27,28 Our study adds to the emerging recognition that there is spectrum of parent participation in interdependent safety behaviors that involve assertive behaviors, such as double-checking or questioning professional practice. 15,25 Various behavioral models could explain why parents and patients perform risk/benefit calculations: will speaking up about a behavior offend staff be worth potentially reducing the risk of infection to my child?…”

Are Parents Who Feel the Need to Watch Over Their Children’s Care Better Patient Safety Partners?

“…Our findings align with those from previous studies in which researchers suggested potential challenges to having patients or families act as partners in patient safety. 15,[18][19][20] Specifically, we found that more parents reported frequently engaging in medication safety behaviors, whereas few parents frequently reminded providers to clean their hands. This finding may be related to attributes of the parent or the desired behavior.…”

“…In addition, by virtue of the need to watch over care, they already possess 2 key attributes that would make them excellent partners in improving patient safety. 20 First, by their endorsement of needing to watch over care to prevent mistakes from happening, it appears they are already aware that mistakes can happen in hospitals. Second, they have a focus on preventing harm, recognizing that through their own actions they may be able to prevent mistakes from being made or detect and correct them before harm occurs.…”

“…These include barriers at the organizational level (eg, willingness of providers to accept patients and families as patient safety partners), personal characteristics of the patient or family (eg, education or health literacy), and characteristics of the type of partnership desired or the behaviors required. 15,[18][19][20][21] Thus, it is possible that although some parents may feel the need to watch over their child' s care, health care systems may be able to do more to support parents as safety partners. Understanding whether this existing need to watch over care translates into the actual performance of specific safety behaviors could guide health care organizations toward next steps in their efforts to engage parents as safety partners.…”