Patient Engagement in Health Care Safety

The study brings safety impact examples for engaging patients with their own care. Authors underline activities such as monitoring and self-administration of medications, alerting care teams to concerning symptoms, and reporting adverse events. Moreover, they highlight evidence-based strategies to support patient and family engagement in promoting safe care and identifies gaps to inform patient safety research and policy agenda.

Patient engagement interventions in clinical and administrative areas are included in the review: anticoagulant self-monitoring or self-titration in thromboembolism, online patients’ portal reducing administrative errors, self-management education in hypoglycemia, patients’ reports of post-marketing adverse events enhancing medication safety and pharmacovigilance, and patient and family discharge education to prevent readmission. Authors also have magnet safety initiatives like patient and family engagement in the hand hygiene program in the clinical setting.

• Available evidence suffers from paradoxical concerns in impact analysis of patient engagement interventions on the safety outcomes. Future work should foster new modalities for patients and families to self-managed care and easy communication with care teams, the innovative use of EMRs, and patients’ participation in system-level safety improvements.

• A range of patient engagement interventions led to improved safety; however, regarding EMR-based patient portals, only a small percentage of patients with higher educational attainment and literacy engaged with portals. For EMRs and patient portals to achieve their full potential as patient engagement tools for safety, policy shifts must encourage interoperable systems that accommodate patients with limited health literacy and English proficiency and facilitate access for caregivers as well.

• Researchers excluded reviews that assessed patient engagement tools to reduce unnecessary medical treatments, such as shared decision making to reduce antibiotic use for upper respiratory infections. They also excluded studies that assessed patient engagement in chronic disease management or reported care quality outcomes that had a risk for patient harm, such as seizure frequency among patients with known epilepsy. Due to this exclusion, patients and family roles in “No Intervention as the Best Intervention” that is beneficial from the patients’ perspectives have been ignored.