title: Modeling the hospital safety partnership preferences of patients and their families: a discrete choice conjoint experiment.
abstract: BACKGROUND
  Patients and their families play an important role in efforts to improve health service safety.
  
  
  OBJECTIVE
  The objective of this study is to understand the safety partnership preferences of patients and their families.
  
  
  METHODS
  We used a discrete choice conjoint experiment to model the safety partnership preferences of 1,084 patients or those such as parents acting on their behalf. Participants made choices between hypothetical safety partnerships composed by experimentally varying 15 four-level partnership design attributes.
  
  
  RESULTS
  Participants preferred an approach to safety based on partnerships between patients and staff rather than a model delegating responsibility for safety to hospital staff. They valued the opportunity to participate in point of service safety partnerships, such as identity and medication double checks, that might afford an immediate risk reduction. Latent class analysis yielded two segments. Actively engaged participants (73.3%) comprised outpatients with higher education, who anticipated more benefits to safety partnerships, were more confident in their ability to contribute, and were more intent on participating. They were more likely to prefer a personal engagement strategy, valued scientific evidence, preferred a more active approach to safety education, and advocated disclosure of errors. The passively engaged segment (26.7%) anticipated fewer benefits, were less confident in their ability to contribute, and were less intent on participating. They were more likely to prefer an engagement strategy based on signage. They preferred that staff explain why they thought patients should help make care safer and decide whether errors were disclosed. Inpatients, those with immigrant backgrounds, and those with less education were more likely to be in this segment.
  
  
  CONCLUSIONS
  Health services need to communicate information regarding risks, ask about partnership preferences, create opportunities respecting individual differences, and ensure a positive response when patients raise safety concerns.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Cunningham
authors.affiliation: Department of Quality and Performance, Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Tracy
authors.initials: T
authors.lastname: Hutchings
authors.affiliation: Department of Quality and Performance, Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Henderson
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University.
authors.forename: Heather
authors.initials: H
authors.lastname: Rimas
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Chen
keywords: discrete choice conjoint experiment; hospital safety; partnerships; patients; preferences