Patient involvement in patient safety: what factors influence patient participation and engagement?
BACKGROUND
Patients can play an important role in improving patient safety by becoming actively involved in their health care. However, there is a paucity of empirical data on the extent to which patients take on such a role. In order to encourage patient participation in patient safety we first need to assess the full range of factors that may be implicated in such involvement.


OBJECTIVE
To delineate factors that could affect the participation of the patient in quality and safety issues in their health care.


METHODS
Literature review of patient involvement in health care, drawing from direct evidence (specifically from the safety context) and indirect evidence (extrapolated from treatment decision-making research and the wider patient involvement in health care literature); synthesis and conceptual framework developed, illustrating the known and putative factors that could affect the participation of the patient in safety issues in their health care.


RESULTS
Five categories of factors emerged that could affect patient involvement in safety: patient-related (e.g. patients' demographic characteristics), illness-related (e.g. illness severity), health-care professional-related (e.g. health care professionals' knowledge and beliefs), health care setting-related (e.g. primary or secondary care), and task-related (e.g. whether the required patient safety behaviour challenges clinicians' clinical abilities).


CONCLUSIONS
The potential for engaging patients in patient safety is considerable but further research is needed to examine the influences on patient involvement, the limits and the possible dangers. Patients can act as 'safety buffers' during their care but the responsibility for their safety must remain with the health care professionals.
Clinical Safety Research Unit, Department of Bio-Surgery and Surgical Technology, QEQM, St Mary's Hospital, London, UK. rachel.davis@imperial.ac.uk
Rachel E
RE
Davis
Rosamond
R
Jacklin
Nick
N
Sevdalis
Charles A
CA
Vincent
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003657:Decision Making; D003710:Demography; D006801:Humans; D010358:Patient Participation / Q000523:psychology*; D011787:Quality of Health Care; D012449:Safety; D012720:Severity of Illness Index