title: Hospitalized patients' participation and its impact on quality of care and patient safety.
abstract: OBJECTIVE
  To understand the extent to which hospitalized patients participate in their care, and the association of patient participation with quality of care and patient safety.
  
  
  METHODS
  Random sample telephone survey and medical record review.
  
  
  METHODS
  US acute care hospitals in 2003.
  
  
  METHODS
  A total of 2025 recently hospitalized adults.
  
  
  METHODS
  Hospitalized patients reported participation in their own care, assessments of overall quality of care and the presence of adverse events (AEs) in telephone interviews. Physician reviewers rated the severity and preventability of AEs identified by interview and chart review among 788 surveyed patients who also consented to medical record review.
  
  
  RESULTS
  Of the 2025 patients surveyed, 99.9% of patients reported positive responses to at least one of seven measures of participation. High participation (use of >4 activities) was strongly associated with patients' favorable ratings of the hospital quality of care (adjusted OR: 5.46, 95% CI: 4.15-7.19). Among the 788 patients with both patient survey and chart review data, there was an inverse relationship between participation and adverse events. In multivariable logistic regression analyses, patients with high participation were half as likely to have at least one adverse event during the admission (adjusted OR = 0.49, 0.31-0.78).
  
  
  CONCLUSIONS
  Most hospitalized patients participated in some aspects of their care. Participation was strongly associated with favorable judgments about hospital quality and reduced the risk of experiencing an adverse event.
authors.affiliation: Center for Patient Safety, Dana-Farber Cancer Institute, Boston, MA 02115, USA. saul_weingart@dfci.harvard.edu
authors.forename: Saul N
authors.initials: SN
authors.lastname: Weingart
authors.forename: Junya
authors.initials: J
authors.lastname: Zhu
authors.forename: Laurel
authors.initials: L
authors.lastname: Chiappetta
authors.forename: Sherri O
authors.initials: SO
authors.lastname: Stuver
authors.forename: Eric C
authors.initials: EC
authors.lastname: Schneider
authors.forename: Arnold M
authors.initials: AM
authors.lastname: Epstein
authors.forename: Jo Ann
authors.initials: JA
authors.lastname: David-Kasdan
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Annas
authors.forename: Floyd J
authors.initials: FJ
authors.lastname: Fowler
authors.forename: Joel S
authors.initials: JS
authors.lastname: Weissman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012189:Retrospective Studies; D012449:Safety