title: PReSaFe: A model of barriers and facilitators to patients providing feedback on experiences of safety.
abstract: The importance of involving patients in reporting on safety is increasingly recognized. Whilst studies have identified barriers to clinician incident reporting, few have explored barriers and facilitators to patient reporting of safety experiences. This paper explores patient perspectives on providing feedback on safety experiences.
  
  
  
  Patients (n=28) were invited to take part in semi-structured interviews when given a survey about their experiences of safety following hospital discharge. Transcripts were thematically analysed using NVivo10.
  
  
  
  Patients were recruited from four hospitals in the UK.
  
  
  
  Three themes were identified as barriers and facilitators to patient involvement in providing feedback on their safety experiences. The first, cognitive-cultural, found that whilst safety was a priority for most, some felt the term was not relevant to them because safety was the "default" position, and/or because safety could not be disentangled from the overall experience of care. The structural-procedural theme indicated that reporting was facilitated when patients saw the process as straightforward, but that disinclination or perceived inability to provide feedback was a barrier. Finally, learning and change illustrated that perception of the impact of feedback could facilitate or inhibit reporting.
  
  
  
  When collecting patient feedback on experiences of safety, it is important to consider what may help or hinder this process, beyond the process alone. We present a staged model of prerequisite barriers and facilitators and hypothesize that each stage needs to be achieved for patients to provide feedback on safety experiences. Implications for collecting meaningful data on patients' safety experiences are considered.
authors.affiliation: School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: Aoife
authors.identifier: 0000-0003-0124-0893
authors.initials: A
authors.lastname: De Brún
authors.affiliation: Social Policy Research Unit, University of York, York, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Heavey
authors.affiliation: Nottingham University Business School, Nottingham University, Nottingham, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Waring
authors.affiliation: Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: Pamela
authors.initials: P
authors.lastname: Dawson
authors.affiliation: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Jason
authors.initials: J
authors.lastname: Scott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005246:Feedback; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D061214:Patient Safety; D036301:Qualitative Research; D012308:Risk Management / Q000379:methods; D011795:Surveys and Questionnaires
keywords: patient experience; patient reporting; patient safety; qualitative research