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

Adverse events
Respondents from the United States were asked about the occurrence of adverse events
in the Commonwealth Fund Survey of Public Views of the US Health Care System
2011. Thirteen per cent said that they or a family member acquired an infection or
complication as a result of medical care and 15% reported experiencing a surgical or
medical error or mistake, including incorrect drug dosage or laboratory results (67).
The 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults
was conducted in eight countries: Australia, Canada, France, Germany, the Netherlands,
New Zealand, United Kingdom and United States. Patients with chronic disease
who had been hospitalized in the previous two years were included. Of these patients,
between 7% (France) and 18% (United States) reported that they had been readmitted to
hospital or went to the emergency room because of complications during recovery (68).
Of all the patients with chronic disease who participated in the survey:
» 6% (the Netherlands) to 14% (United States) reported that they had been given
incorrect medication or doses;
» 8% (United Kingdom and France) to 17% (Australia) reported a medical mistake in
treatment; and
» 1% of those who had been subject to laboratory tests in the Netherlands to 7% in
Australia and the United States reported having been given incorrect results.
Most errors in medication, treatment or laboratory testing occurred outside the hospital.
Safety management
Of the hospitalized patients in the 2008 Commonwealth Fund International Health
Policy Survey of Sicker Adults, 8% (United States) to 17% (United Kingdom) reported
that they had not been given instructions about symptoms and when to seek further
care. Forty per cent (Canada) to 68% (France) who regularly took prescription medicines
reported that doctors or pharmacists sometimes/rarely/never reviewed and discussed all
the medications they were using.
Netherlands CQI
The CQI was introduced by the Netherlands Ministry of Health, Welfare and Sports
in 2006 as the national standard for measuring patient experiences with health care
providers and health plans. The CQI is a registered trademark that is owned by the
Centre for Consumer Experience in Health Care, which coordinates the development
of CQI surveys and collects emerging data. CQI questionnaires measure patient
experiences rather than patient satisfaction (53). Patient experience questionnaires ask
whether certain processes and events occurred, combined with questions about values
and expectations with regard to health care.
Currently, 22 sets of questionnaires have been developed, covering health and social care
literally from the cradle (perinatal care) to the grave (palliative care). CQI questionnaires
cover services such as long-term care for older people, home care, mental health care,
general practice, physiotherapy, hospital care, elective surgery, haemodialysis and
Patients’ experiences and patient safety
127