Exploring patient participation in reducing health-care-related safety risks

ChApTER 6.
pATIENT pARTICIpATION IN ELECTIVE
SURGERY SAFETY IN pORTUGAL
Anna Mansoa
Patient participation in elective surgery safety in Portugal
Introduction
The complexity of health care services all over the world presents new challenges in
assuring service quality and safety (1). Patient safety is an important aspect of public
health and a recognized key issue in establishing and delivering accessible, cost-effective
and responsive health care (2,3).
It has already been shown that medical errors and health care-related adverse events
occur in between 8% and 12% of hospitalizations within EU Member States (1), with a
large percentage being considered preventable (3). HAIs are the most frequent adverse
event threatening patients’ safety worldwide, with an estimated prevalence of 7.1% in
Europe (1,4).
Enhancing patient safety, defined as “freedom for a patient from unnecessary harm or
potential harm associated with health care” (1,3), and assuring the protection of patients’
rights is high on national and international health agendas. Patient participation, a
key component in the redesign of safe health care, is advocated as a means to improve
patient safety in several areas, such as the management of chronic diseases (5). It is
consequently being promoted by WHO as a means to improve well-being and increase
the efficiency of the health care system through enhanced communication between
patients and health care providers.
“Patients for Patient Safety”, one of WHO’s main actions involving work with a global
network of patients, consumers, caregivers and consumer organizations, launched the
London Declaration in 2006 (6). This advocates for the reduction of health care errors as a
basic human right and emphasizes the importance of strengthening patient engagement
(1). Patients can contribute to safer health care experiences by being involved in, and
informed about, their treatment (7). Fewer adverse events are likely to occur when
patients and HCWs become partners in health care, sharing important information,
managing systemic risks and dealing with adverse events (8).
Even if more evidence on the role of patient participation in preventing medical errors
is needed, existing research shows that patients can influence and substantially modify
HCWs’ behaviour. However, the efficacy and implementation of patient participation
in preventing medical errors and increasing staff adherence can be influenced by a
multitude of cultural and environmental factors (5). The acknowledgment that only an
informed patient can be really engaged in his or her own health care and contribute to
the quality of services brought the importance of effective policies promoting health
literacy to the international agenda (5).
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