From the Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Icahn School of Medicine at Mount Sinai, New York City, New York.
J Patient Saf. 2021 Aug 1;17(5):358-362. doi: 10.1097/PTS.0000000000000699.
In an adverse event investigation, the patients have the potential to add a unique perspective because they can identify contributing factors that providers may miss. However, patients are rarely included in patient safety investigations. We aimed to identify the barriers to patient involvement in patient safety investigations and propose strategies to overcome them.
We reviewed literature on active participation by patients in safety investigations to construct a framework for healthcare institutions to use in approaching patients about a potential role in investigating an error in their care. We searched 3 electronic databases (PubMed, PSNet, Web of Science) for the years 1990 to 2018, without restrictions to language. Search terms included: "patient empowerment, "patient involvement," "patient participation," "patient safety investigation," "root cause analysis," "error analysis." We also examined reference lists of relevant studies to identify additional articles.
Our electronic search produced 10,624 records with 30 potentially eligible articles. However, we identified only 6 relevant published articles. We used these as the basis for a proposed framework that is predicated on the thoughtful disclosure of adverse events and has 3 main levels (i.e., patient, clinician, and institutional level). For each level, we identify barriers to patient participation and potential strategies to overcome them.
The proposed framework can be used as a starting point to promote patient involvement in error investigations. Involving patients in patient safety investigations could increase patient centeredness, patient autonomy, and transparency and make analyses more effective by adding unique and potentially actionable information.
在不良事件调查中，患者有可能提供独特的视角，因为他们能够识别出提供者可能遗漏的促成因素。然而，患者很少被纳入患者安全调查。我们旨在确定患者参与患者安全调查的障碍，并提出克服这些障碍的策略。
我们回顾了患者在安全调查中积极参与的文献，为医疗机构构建了一个框架，用于在调查患者护理中的潜在错误时，让患者参与调查。我们在 1990 年至 2018 年间，在 3 个电子数据库（PubMed、PSNet、Web of Science）中进行了无语言限制的搜索。搜索词包括：“患者赋权”、“患者参与”、“患者参与”、“患者安全调查”、“根本原因分析”、“错误分析”。我们还检查了相关研究的参考文献，以确定其他文章。
我们的电子搜索产生了 10624 条记录，其中有 30 篇可能符合条件的文章。然而，我们只确定了 6 篇相关的已发表文章。我们以此为基础提出了一个框架，该框架基于对不良事件的深思熟虑的披露，有 3 个主要层次（即患者、临床医生和机构层面）。对于每个层次，我们确定了患者参与的障碍和潜在的克服策略。
所提出的框架可以作为促进患者参与错误调查的起点。让患者参与患者安全调查可以通过增加独特且潜在可操作的信息，提高以患者为中心、患者自主权和透明度，并使分析更有效。
