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

ChApTER 2.
pATIENTS’ RIGhTS AND pATIENT
SAFETY
Johan Legemaate
Introduction
Attention to patient safety in health care has increased considerably since the turn of
the century. Patient safety relates to the reduction of risk and is defined as “freedom
from accidental injury due to medical care, or medical errors” (1). Patient safety is about
managing this risk using a variety of policies and instruments including, but not limited
to, building a safety culture, developing clinical guidelines, reporting and analysing
adverse events, training doctors and other health professionals in quality and safety
management and, last but not least, empowering patients.
The broader context of patient safety is clearly described by WHO Regional Office for
Europe (2):
Patient safety is a serious concern all over the world, as a consequence of increased awareness
of the issue. While health care has become more effective it has also become more complex,
with greater use of new technologies, medicines and treatments. Health services are treating
older and sicker patients who often present with significant co-morbidities requiring
increasingly difficult decision-making in health care prioritization. Economic constraints are
leading to often overloaded and besieged health care environments. Reduced revenues and
increasing expenditures in times of financial crisis are likely to further contain costs, and thus
affect service quality and patient safety.
Patient safety is a global issue. Numerous initiatives have been put in place at national
and international levels to develop sound patient safety infrastructures that aim to
reduce the number of patients unintentionally harmed while receiving medical care (2).
Data gathered from studies performed in the United States, Australia and a number of
western European countries suggest that between 8% and 12% of patients admitted to
hospital experience adverse events while receiving health care (3). The number may be
even higher due to significant and widespread underreporting of adverse events.
This background chapter describes and analyses regulatory aspects of patient safety and,
more specifically, the relationship between patient safety developments and patients’
rights. The aim is to explore the legal context of patient safety with a focus on obligations
and opportunities to increase patient involvement and participation in safety and quality
of care issues. An analysis of the relationship between patient safety and patients’ rights
can help to identify legal issues that policy-makers should take into account when trying
to reduce risks and unintentional damage in health care. These may include legislation
and supportive measures and activities necessary to make legislation work.
Patients’ rights and patient safety
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