Beleffi Elena, Mosconi Paola, Sheridan Susan
Centre for Clinical Risk Management and Patient Safety, Tuscany Region—WHO Collaborating Centre in Human Factors and Communication for the Delivery of Safe and Quality Care, Florence, Italy
Laboratory for Medical Research and Consumers Involvement, Public Health Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
The wide implementation of patient safety improvement efforts continues to face many barriers including insufficient involvement of all stakeholders in healthcare, lack of individual and organizational learning when medical errors occur and scarce investments in patient safety. The promotion of systems-based approaches offers methods and tools to improve the safety of care. A multidisciplinary perspective must include the involvement of patients and citizens as fundamental contributors to the design, implementation, and delivery of health services. The patient journey is a challenging example of using a systems approach. The inclusion of the patient’s viewpoint and experience about their health journey throughout the time of care and across all the care settings represents a key factor in improving patient safety. Patient engagement ensures that the design of healthcare services are aligned with the values, the preferences, and needs of the patient community and integrates the real-life experience and the skills of the people to enhance patient safety in the patient journey. The utmost priority to implement patient engagement is the training of patients. Therefore, training for both patients/families/advocates and health professionals is the foundation on which to build active engagement of patients and consequently an effective and efficient patient journey. The chapter offers examples of successful training courses designed to foster strategic alliances among healthcare professionals and researchers with patients and their organizations. Training of patients constitutes the first step to develop shared knowledge, co-produced projects, and the achievement of active multilevel participation of patients for the implementation of patient safety in the patient journey.
患者安全改善措施的广泛实施仍面临诸多障碍,包括医疗保健领域所有利益相关者的参与不足、医疗差错发生时个人和组织缺乏学习以及对患者安全的投资稀缺。推广基于系统的方法可提供改善医疗安全的方法和工具。多学科视角必须包括患者和公民的参与,他们是卫生服务设计、实施和提供的重要贡献者。患者就医过程是运用系统方法的一个具有挑战性的例子。在整个护理期间以及所有护理环境中纳入患者对其健康历程的观点和体验,是提高患者安全的关键因素。患者参与可确保医疗服务的设计符合患者群体的价值观、偏好和需求,并整合人们的现实生活经验和技能,以在患者就医过程中提高患者安全。实施患者参与的首要任务是对患者进行培训。因此,对患者/家属/倡导者和卫生专业人员的培训是促进患者积极参与并进而实现有效且高效的患者就医过程的基础。本章提供了一些成功培训课程的示例,这些课程旨在促进医疗专业人员和研究人员与患者及其组织之间建立战略联盟。对患者的培训是发展共享知识、共同开展项目以及实现患者在患者就医过程中积极参与多层次实施患者安全的第一步。