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

More documents

Recommendations

Info

Exploring patient participation in reducing health-care-related safety risks 60 Information system Rieux & Nguyen (21) suggest the allocation of human resources to haemovigilance varies depending on the hospital. In everyday practice, haemovigilance correspondents in hospitals are often compelled to carry out activities beyond their scope (notably transfusion safety activities). Health care facilities’ haemovigilance correspondents have been able to declare RARs directly via an electronic system (Fig. 4.8) since 2004: there were 271 such declarations in 2009, constituting 60% of all RARs from the dedicated electronic database (6). Fig . 4 .8 . Number of health facilities declaring at least one transfusion adverse event through the established declaration process, 2000–2009 Source: AFSSAPS (6). Number of transfused patients: 538 506 Number of LBPs distributed: 2 979 170 Number of RAR declarations: 7 808 Number of confirmed cases of RAR of imputability 2 to 4: 5 902 Ratio per 1 000 LBPs distributed: 2.0 Huge efforts have been made to computerize transfusion files, despite difficulties, but outcomes remain highly variable. Securing the improvement and computerization of data exchange between the EFS and hospitals constitutes a priority for the haemovigilance network. Haemovigilance correspondents should have access to all the information they need in the transfusion chain (21). It is also important to define the number and nature of undeclared adverse events. Another important limitation of haemovigilance systems is the difficulty associated with capturing information on transfusion-transmitted infections that have prolonged latency periods. New strategies need to be developed to try to capture comprehensively this type of adverse event (22). The development and systematization of medical information is probably a key element for users’ participation in health care systems, as it can give individuals the means to express their preferences and to negotiate their own care pathway (with the health care organization and with their GP) (23). Management of PDI is also of vital importance in blood safety. PDI comprises any information about the donor declared or discovered after a donation that can affect recipient safety or the quality of the LBP. In 2009, 14 809 LBPs were destroyed following PDI reports indicating problems with the blood donor. The number of PDI declarations has multiplied five-fold since 2003, reaching 1295 in 2009. The rate of
Blood transfusion safety in France: developing tools to support patients declaration reached to date is 3.9 per 10 000 samples. The information covered includes transmissible disease markers, risky donor behaviour, clinical or biological anomalies, and nonconventional transmissible agent transmission risks. The declaration of certain donor-related information obtained after donation is not regulated but is covered by an agreement between the AFSSAPS, the French blood agency and CTSA. The recommended deadline varies from 48 hours to 15 days after obtaining the information. The declaration is only submitted to the AFSSAPS if the LBPs from the donations in question have left the blood agency. Traceability enables the link between the delivered LBP and the recipient, while preserving the confidentiality of the donor and the medical anonymity of the recipient. In the case of adverse events, the investigation moves in an “upstream” direction through the different steps of the transfusion chain, identifying potential causes and taking corrective measures. The crucial role of information: theoretical aspects Context: a strong social request for information Information is ubiquitous nowadays, triggering what Lienhart & De Traverse (16) have described as a “strong request” for information from the public. According to Expert 13, the Head of the School of International Languages, Literatures and Cultures, patients want increasingly more information. Thieblemont et al. (24) talk about a “new exigency for information” and associate this movement with the development of information technologies and the abundance of medical web sites. What is missing in this abundance of sources, however, is information that is reliable and referenced (Expert 10). The role of information in the evolution of the patient–doctor relationship According to Noirez (25), information can have two very different goals: to legally protect medical doctors in a medico-legal context, and to involve patients in their care decisions. Informing patients is a fundamental step in this direction: for Ghadi (26), informing patients is “a way to respect their autonomy and dignity”. The growing importance of information has progressively transformed the relationship between patient and doctor. Critical thinking about medicine has developed within the general public, leading health authorities to start considering patient participation in therapeutic decisions with doctors, who hold medical knowledge and legal responsibility. The evolution of the patient–doctor relationship and the decline of what was known as the “paternalist model” have mainly been triggered by the increasing role of information in society. According to Ghadi (26), the active involvement of patients in their care is a necessary condition of a truly trustful relationship with health care professionals and the health care system. Further patient engagement in health care is strongly supported by patients’ organizations. Adapting information given to patients A study carried out in 2002 (17) which assessed patients’ understanding of information on transfusion and related risks showed a gap between their perception and the actual 61
Page 1 and 2:
Exploring patient participation in
Page 3 and 4:
ABSTRACT Patients’ rights have be
Page 5 and 6:
iv Patient information: the link be
Page 7 and 8:
vi LIST OF TABLES, FIGURES AND BOXE
Page 9 and 10:
ACKNOWLEDGEMENTS The editors would
Page 11 and 12:
LIST OF ABBREVIATIONS ABHR alcohol-
Page 13 and 14:
FOREWORD Health is a social value a
Page 15 and 16:
ChApTER 1. pATIENTS’ RIGhTS AND p
Page 17 and 18:
Box 1 .1 . contd Reporting and Lear
Page 19 and 20:
The causal mechanisms through which
Page 21 and 22:
» be involved in routine monitorin
Page 23 and 24: elationships within the complex env
Page 25 and 26: ChApTER 2. pATIENTS’ RIGhTS AND p
Page 27 and 28: CoE Recommendation 2006/7 of the Co
Page 29 and 30: The 2005 United States act on patie
Page 31 and 32: The right to participate in policy-
Page 33 and 34: The right to participate in quality
Page 35 and 36: » engaging with patient representa
Page 37 and 38: hampered by the written and spoken
Page 39 and 40: prevents misunderstandings and shap
Page 41 and 42: Health care providers should nevert
Page 43 and 44: Recommendation 7 - Encourage the av
Page 45 and 46: 20. Constitution of the World Healt
Page 47 and 48: ChApTER 3. pATIENT pARTICIpATION IN
Page 49 and 50: awareness of the sociomedical burde
Page 51 and 52: Patient participation in hand hygie
Page 61 and 62: Blood transfusion safety in France:
Page 65 and 66: Box 4 .1 . Definitions of adverse e
Page 67 and 68: Fig . 4 .4 . Distribution of advers
Page 73: The heterogeneity of situations and
Page 83 and 84: Fig . 4 .12 . Patients’ response
Page 91 and 92: Patient safety, rights and medicati
Page 97 and 98: Fig . 5 .3 . Frequency with which d
Page 107 and 108: ChApTER 6. pATIENT pARTICIpATION IN
Page 109 and 110: Patient participation in elective s
Page 111 and 112: e desirable to have a special statu
Page 117 and 118: inspections of surgical services to
Page 125 and 126:
Patient participation in elective s
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
» being involved in monitoring and
Page 135 and 136:
Other studies on patient attitudes
Page 137 and 138:
Information about patients’ exper
Page 139 and 140:
available evidence suggests that in
Page 141 and 142:
Adverse events Respondents from the
Page 143 and 144:
Feeling safe Five per cent of hospi
Page 145 and 146:
probability proportional to populat
Page 147 and 148:
care professionals’ and patients
Page 149 and 150:
group recommends that patient invol
Page 151 and 152:
13. Hibbard JH et al. Can patients
Page 153 and 154:
52. Triemstra M et al. Measuring cl
Page 155 and 156:
2009 (http://www.bradfordresearch.n
Page 157 and 158:
of a small-scale patient survey add
Page 159 and 160:
Box 8 .2 . Curricula and CME Chapte
Page 161 and 162:
is provided through interaction of
Page 163 and 164:
Box 8 .4 . Patient education Chapte
Page 165 and 166:
ANNEX 1. QUOTATIONS FROM INTERNATIO
Page 167 and 168:
(2) When designing adverse event re
Page 169 and 170:
17) If yes, do you think this was m
Page 171 and 172:
Box A3 .1 . Reporting procedure Pat
Page 173 and 174:
Box A3 .2 . contd Haemosiderosis Ha
Page 175 and 176:
ANNEX 4. pATIENT QUESTIONNAIRE ABOU
Page 177 and 178:
ANNEX 6. WhO pATIENT SAFETY pROGRAM
Page 179 and 180:
especially those in intensive care.
Page 181 and 182:
ANNEX 7. hANDOVER pROjECT Paul Bara
Page 183 and 184:
(a) Provide new insight into the ro
Page 185 and 186:
Johnson J, Barach P. Handovers of p
Page 187 and 188:
Enhancing the patients’ role in p
Page 189 and 190:
Enhancing the patients’ role in p
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?