Patient engagement for patient safety: The why, what, and how of patient engagement for improving patient safety (OECD Health Working Paper, 15 September 2023)

Summary

Patients’ perspectives and their active engagement are critical to make health systems safer and people-centred, and are key for co-designing health services and co-producing good health with healthcare professionals, and building trust in health systems.

This report, which forms part of a series of Organisation for Economic Co-operation and Development (OECD) papers on the economics of patient safety, looks (i) the economic impact of patient engagement for patient safety; (ii) the results of a pilot data collection to measure patient-reported experiences of safety and; (iii) the status of initiatives on patient engagement for patient safety taken in 21 countries, which responded to a snapshot survey.

Content

Key findings in this report include:

• According to the surveys conducted, up to about one in six patients reported safety incidents. Up to 8% of patients experienced medication errors.
• Less than half of countries (9 out of 21) responded to the OECD survey on Patient Engagement for Patient Safety reported having systems of no-fault liability in place to compensate patients who suffer any treatment-induced injury irrespective of conviction for medical malpractice or negligence. Countries that indicated having a system of no-fault compensation to patients include Austria, Belgium, France, Japan, Korea, Latvia, New Zealand, Portugal, and Switzerland
• Over a third of OECD countries (e.g., Austria, Belgium, Canada, Estonia, Latvia, Poland, and the United States) have conducted at least one survey that includes questions measuring patient-reported experiences of safety among adult patients who were discharged from the hospital.
• Most countries engage patients or citizens during the development cycle of patient-safety initiatives, but the level of engagement varies both within and across countries.
• Nearly all countries (20 out of 21) reported having a national patient safety policy or strategy. In 15 out of 20 countries, national patient safety policies or strategies included explicit references to patient engagement, and more than half (11 out of 20) engaged patients or citizens in the development of the policy.
• Most countries have a legal right to safe patient care, but just over half reported having mechanisms in place to enforce that right, such as legal recourse or alternative courses of action. Of the countries with a legal right to safe patient care, half indicated that patients and citizens were engaged in the development of the legal structure.

Recommendations

The report provides seven key recommendations for enhancing patient engagement for patient safety:

1. Building trust for safer healthcare through stronger patient and family engagement.
2. Institutionalising patient engagement for patient safety.
3. Establishing better platforms and networks for sharing experiences and good practices in patient engagement.
4. Strengthening patient engagement for patient safety at institution and clinical levels.
5. Enhancing monitoring of patient safety for keeping track of progress and building accountability.
6. Anchoring collection and use of patient safety data to OECD’s Recommendations of the Council on Health Data Governance.
7. Improving quality of patient-reported safety indicators and systematically using them for improving patient safety.

Previous OECD Health Working Papers on patient safety issues

• Advancing patient safety governance in the Covid-19 response (3 February 2023)
• The economics of medication safety: Improving medication safety through collective, real-time learning (14 September 2022)
• The economics of patient safety Part IV: Safety in the workplace. Occupational safety as the bedrock of resilient health systems (10 September 2021)
• The Economics of Patient Safety. From analysis to action (21 October 2020)
• System governance towards improved patient safety: Key functions, approaches and pathways to implementation (17 September 2020)
• The economics of patient safety Part III: Long-term care (17 September 2020)
• System governance towards improved patient safety: Key functions, approaches and pathways to implementation (17 September 2020)
• Culture as a cure: Assessments of patient safety culture in OECD countries (2 June 2020)
• The economics of patient safety in primary and ambulatory care: Flying blind (November 2018)