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

available evidence suggests that individual consumers do not often use this information
(yet) to select better-performing providers over those performing less well (see, for
example, Faber et al. (63)), but that publicly releasing performance data stimulates
quality improvement activity at hospital level. Improvement of publicly released
performance scores have also been demonstrated for the CQI in the Netherlands (64).
Results of screening patient experience questionnaires
Questions have been identified on:
» the occurrence of adverse events as reported by patients in patient experience
questionnaires;
» the occurrence of factors that are known to contribute to or to prevent adverse
events (safety management);
» safety as an experience (trust; the concept of “feeling safe”); and
» actual involvement in safety management.
CAHPS surveys in the United States
The CAHPS programme is a public–private initiative to develop standardized surveys of
patients’ experiences with ambulatory and health care facility-level care. CAHPS results
are used to assess the patient centredness of care, to compare and report on performance,
and to improve the quality of care (65).
The following surveys have been reviewed for this study:
» CAHPS Health Plan Survey, which asks enrolees about their recent experiences
with health plans and their services;
» CAHPS Clinician and Group Survey, about recent experiences with physicians and
their staff;
» CAHPS Surgical Care Survey, about surgical care, surgeons, their staff and
anaesthetists;
» CAHPS Hospital Survey, about experiences with inpatient care in medical, surgical
or obstetrics departments;
» CAHPS In-centre Haemodialysis survey, about experiences with haemodialysis;
» CAHPS nursing home surveys, which include three separate instruments – a
personal structured interview for long-term residents, a postal questionnaire for
recently discharged short-stay residents and a postal questionnaire for residents’
family members; and
» CAHPS Item Set for Addressing Health Literacy.
The Health Plan Survey, Clinician and Group Survey (adult specialty care and adult
primary care) and the Item Set for Addressing Health Literacy do not include items
that are related to patient safety. Items relating to safety are found in the In-centre
Haemodialysis Survey, the Nursing Home Survey and the Surgical Care Survey.
Items related to safety in the CAHPS In-centre Haemodialysis Survey
“In the last three months, how often did dialysis center staff check you as closely as you
wanted while you were on the dialysis machine?”
Patients’ experiences and patient safety
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