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

Exploring patient participation in reducing health-care-related safety risks
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Box 8 .3 . Public consumer information
Chapter 2, Recommendation 3 – Provide individual patients with relevant information
Information and communication are key words in this process. Patient participation starts with the availability of
valid, clear and relevant information at various levels, including information related to:
» the basis on which patients can differentiate between (the quality and safety of ) health care providers;
» the patient’s health situation, available treatment options and potential risks to the patient’s safety; and
» how to get involved in patient safety activities.
Chapter 7, Recommendation 3 – Measure and publish patients’ experiences with safety management
A way to improve hospitals’ performance might be the public disclosure of patients’ experiences with aspects of
care. Disclosure of substandard performance triggers professionals and managers to improve the quality of care,
and it encourages patients to choose safe hospitals. Examples in Chapter 7 prove that it is possible to measure
patients’ experiences with various aspects of health care safety.
Consumer web sites offer a means of communicating information about health care
providers’ performance. Consumer information about the quality and safety of health
care providers in the Netherlands is presented on various web sites (see Chapter 2). In
Portugal, a national health care institution evaluation system – the SINAS – is being
developed. The intention behind the SINAS is to evaluate health care institutions
according to ratings within different parameters, such as clinical excellence (already
implemented), patient safety, infrastructure, and – in future – patients’ satisfaction and
comfort (see Chapter 6).
As is the case in the Portuguese example, information about the performance of health
care providers with respect to patient safety should be derived from a variety of sources.
After all, patient surveys only reflect patients’ perspectives on safety: many aspects of
safety management take place “behind the scenes”, out of patients’ sight (see Chapter 7).
Legemaate (Chapter 2) therefore recommends combining information from different
sources: incidents reported by health professionals or patients, complaints filed by
patients with a complaints official or committee, claims for compensation for damage
due to an alleged medical error, and so on.
Safety management of care delivered by chains of providers presents a difficult problem.
Almost all the experts interviewed about blood transfusion safety in France, for instance,
identified a need to involve GPs in follow-up tests because there is a lack of awareness on
the part of GPs about the importance of post-transfusion check-up tests (see Chapter 4).
Similarly, the authors of Chapter 7 demonstrate that there is room for improvement in
discharge management in hospitals in United Kingdom (England) and the Netherlands,
particularly in relation to telling patients what to do in case of an emergency at home or
what signals or side-effects to look out for after hospital discharge. The question arises
as to who is responsible for integrated safety management. In social insurance systems,
health insurers could play a role in this process, including being responsible for integrated
care and safety. To be able to fulfil that role, health insurers should actively solicit the
opinions and experiences of their enrolees (see Chapter 2).
Micro level
The micro level refers to the primary process in which health care provision and
consumption takes place. It is important to make a distinction here between care that