Patient engagement is increasingly recognised as being crucial to improving health outcomes and the overall quality of life of patients and their families. If successfully implemented, patient engagement can significantly contribute to a reduction in adverse events, which place a significant burden on patients, health systems and even economies. Patient engagement has been shown to reduce health care costs, positively influence patients’ experiences with health care, improve patient outcomes and improve the performance of health systems.

This advocacy brief sets out why patient engagement is a cornerstone for improving patient safety and considers what progress is being made globally towards increasing this in healthcare. It notes that implementation strategies outlined in the Global Patient Safety Action Plan 2021-2030 aimed at reducing harm through patient engagement include:

• Co-developing policies and programmes with patients.
• Learning from patient experiences for safety improvement.
• Building the capacity of patient advocates and patient safety champions.
• Establishing a culture of openness and transparency through initiatives such as shared decision-making, patient reporting systems, and disclosure of patient safety incidents to patients and families.
• Providing patient safety and patient engagement education to patients, community members and health and care workers.

It also identifies the following global actions to strengthen patient engagement for patient safety:

• Strengthen the WHO Patients for Patient Safety programme.
• Establish Patients for Patient Safety networks in every country.
• Embed patient engagement in the principles and practice of patient safety through national patient safety rights charters.
• Increase public awareness and provide information and education about patient safety.
• Amplify the voice of patients as a force for the improvement of patient safety.

It goes on to consider this the role of different actors in patient and family engagement, including:

• Patients, families and caregivers
• Governments
• Healthcare leaders
• Health facilities and services
• Patient groups and other stakeholders
• Health and care workers. 

At the end of this brief, the WHO calls on all stakeholders to assume their respective roles in patient engagement for patient safety and to implement the Global Patient Safety Action Plan’s suggested actions for effective patient and family engagement.

• 27% of countries that have developed a national patient safety action plan or equivalent
• 13% of countries that have a patient representative on the governing board (or an equivalent mechanism) in 60% or more hospitals
• 18% of countries that publish an annual report on patient safety
• 36% of countries that have implemented a system for reporting of never events (or sentinel events)
• 20% of countries that have incorporated a patient safety curriculum in education programmes or courses for health care professionals
• 31% of countries that have established their national targets on reducing health care-associated infection rate
• 18% of countries that have signed up for implementation of the WHO Health Worker Safety Charter
• 22% of countries that have established a national patient safety network
• 18% of countries that have established their national targets on reducing medication related harm
• 31% of countries that have 60% or more health care facilities participating in a patient safety incident reporting and learning system

•  Activities and events held by WHO headquarters, regional offices and country offices.
• National events, conferences and webinars held in different member states.
• Publications and videos highlight key issues relating to World Patient Safety Day, including a blog by Patient Safety Learning and a Patient Safety Spotlight Interview with Angela Carrington, Lead Pharmacist for Medication Safety In Northern Ireland.
• Involvement of patients and healthcare professionals in events and activities.
• Media coverage.

Sunday 17 September 2023 marks the fifth annual World Patient Safety Day. Its objectives are to increase public awareness and engagement, enhance global understanding, and work towards global solidarity and action by Member States to enhance patient safety and reduce patient harm.

The theme for this year’s event is “Engaging patients for patient safety”.[1]

At Patient Safety Learning we believe that patient engagement is key to improving patient safety and identify this as one of the six foundations of safer care in our report, A Blueprint for Action.[2] We believe that patients should be engaged for safety at the point of care, if things go wrong, in improving services, advocating for changes and in holding the system to account.

Evidence shows that when patients are treated as partners in their care, significant gains are made in safety, patient satisfaction and health outcomes. By becoming active members of the healthcare team, patients can contribute to the safety of their care and that of the healthcare system as a whole.

“Hear the patient. Empower the voice of the people we are trying to help. They have more information than just about anyone else in the system.” (Professor Don Berwick)

Engaging patients and the Global Patient Safety Action Plan

Patient and family engagement are embedded in the World Health Assembly Resolution WHA72.6 – “Global action on patient safety”. This is also identified as one of the seven strategic objectives of the Global Patient Safety Action Plan 2021-2030, which sets out a number of actions for the World Health Organization (WHO), governments, healthcare facilities and key health and social care stakeholders on this. Describing the importance of patient engagement for improving patient safety, the Plan states:

“Patient engagement and empowerment is perhaps the most powerful tool to improve patient safety. Patients, families and other informal caregivers bring insights from their experiences of care that cannot be substituted or replicated by clinicians, managers or researchers. This is especially so for those who have suffered harm. Patients, families and caregivers can serve as vigilant observers of a patient’s condition and can alert health care professionals when new needs arise. Given proper information, the patient and family can help to be the eyes and ears of the system.”[3]

Objectives of World Patient Safety Day 2023

Through the slogan “Elevate the voice of patients!”, WHO is calling on all stakeholders to take necessary action to ensure that patients are involved in policy formulation, are represented in governance structures, are engaged in co-designing safety strategies, and are active partners in their own care.

 As part of this, they have set four objectives for this year’s event:

1. Raise global awareness of the need for active engagement of patients and their families and caregivers in all settings and at all levels of healthcare to improve patient safety.
2. Engage policy-makers, healthcare leaders, health and care workers, patients’ organisations, civil society and other stakeholders in efforts to engage patients and families in the policies and practices for safe healthcare.
3. Empower patients and families to be actively involved in their own healthcare and in the improvement of safety of healthcare.
4. Advocate urgent action on patient and family engagement, aligned with the Global Patient Safety Action Plan 2021–2030, to be taken by all partners.

References

1. WHO, World Patient Safety Day 2023: Engaging Patients for Patient Safety, 17 September 2023.
2. Patient Safety Learning, The Patient-Safe Future: A Blueprint for Action, 2019.
3. WHO, Global Patient Safety Action Plan 2021-2030, 3 August 2021.

Related reading

You can find a wide range of personal stories, good practice resources and research on this topic on our patient engagement section of the hub. You also may find the below articles of particular interest:

• How can patients' voices be heard and acted upon when they attempt to report incidents of harm?
• Patient Safety Spotlight interview with Soojin Jun, Co-founder of Patients for Patient Safety US
• Tokenism in patient engagement is unethical—but it is also dangerous. A blog by Kath Sansom
• Patient Safety Spotlight interview with Jono Broad, Quality Improvement through Patient Involvement

• negative attitudes of healthcare providers,
• health information in formats that cannot be understood, or
• difficulties accessing a health centre due to the physical environment, lack of transport or financial barriers.

9789240063600-eng.pdf

WHO states that medication harm accounts for around 50% of the overall preventable harm in medical care and comes with a huge financial cost, estimated at $42 billion USD annually.

Patients can be subject to avoidable harm as a result of medication in a range of different ways, including:

• prescription errors—being underprescribed or overprescribed medicines or receiving a prescription which does not address the health condition and subsequently results in deterioration.
• dosage errors—missed doses or incorrect doses, which can occur in a range of different settings.
• mistakes in administration—such as administering a medicine which should be take intravenously by the intrathecal route.

Global Patient Safety Challenge

This year World Patient Safety Day, on Saturday 17 September 2022, is focused on medication safety. It is intended to build on the existing WHO Global Patient Safety Challenge: Medication Without Harm. Formally launched in 2017, the aim of this is to reduce severe avoidable medication-related harm by 50% in the next five years. This challenge focuses on three key action areas:

1. Medication safety in polypharmacy—this concerns is the concurrent use of multiple medications. Although there is no standard definition, it is often defined as the routine use of five or more medications.
2. Medication safety in high-risk situations—this concerns circumstances where the medication being used may be associated with a particularly high risk of harm, where provider and patient factors that may increase the level of risk and where system factors (work environment) that may increase the level of risk.
3. Medication safety in transitions of care—this concerns the various points where a patient moves or returns from a particular physical location or makes contact with a healthcare professional for the purposes of receiving healthcare,

Each of these actions are mapped against four different domains where greater awareness and action is required:

1. Patients and the public

• Public awareness and medication literacy
• Patient engagement
• Reporting by patients
• Involvement of patient organisations

2. Health care professionals

• Education and training
• Communication and teamwork
• Capability at point of care
• Incident reporting and learning

3. Medicines

• Product quality and safety
• Naming, labelling, and packaging
• Logistics, storage, and disposal
• Right product at point of care

4. Systems and practices of medication

• Leadership and governance
• Prescribing, preparation, and dispensing
• Administration and patient monitoring
• Monitoring and evaluation

5 Moments for Medication Safety tool

As part of this Challenge, WHO has developed a patient engagement tool: 5 Moments for Medication Safety. This looks at the key points where a patient or carer can reduce the harm associated with the use of medication/s, with the intention of empowering them to be involved in their care and patient safety.

Medication Safety webinar series

WHO has recently run a series of excellent webinars with global experts, healthcare professionals and patients, to introduce the strategic framework for implementation of this Global Challenge. These include strategies, tools, and technical support to countries for reducing medication-related harm, in addition to sharing country and patient experiences of implementing the challenge. Recordings and presentations from each of these webinars can be accessed below:

• WHO Global Patient Safety Challenge: Medication Without Harm & World Patient Safety Day 2022 (8 February 2022)
• Engaging Patients and Families for Medication Safety (8 March 2022)
• Medication Error Reporting and Learning Systems, and Pharmacovigilance (12 April 2022)
• Medication Safety in High-risk Situations (17 May 2022)
• Medication Safety in Transitions of Care (7 June 2022)
• Medication Safety in Polypharmacy (12 July 2022)

Related reading

You can find a wide range of articles related medication safety, including research, risks, opinion pieces and examples of good practice, on the hub.

You can also find a number of examples of medication error traps, situations which could lead to avoidable harm if not mitigated, on the hub error traps gallery.