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

Exploring patient participation in reducing health-care-related safety risks
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to internal medicine wards and ICUs are caused by medication errors. Many studies
mention that the problem of medication safety is addressed by the CoE in its
recommendation on management of patient safety and prevention of adverse events in
health care (1), specifically in the section on “Medication safety – a specific strategy to
promote patient safety”.
Most research in this area concentrates on the hospital sector, with the majority of
studies on medication safety relating to tertiary hospital care and focusing on the process
and design of care or on health care staff. As yet, not much international research
relating to patient involvement in medication safety at different levels of care delivery
has been carried out. Such studies tend to be widely dispersed, located within legislation,
accreditation manuals, patient information leaflets and aids, and address patients’ rights
to access their own medical records, to provide informed consent regarding medical
treatment and diagnostics, to receive visitors or to make a phone call.
The aspects of patient safety rights at EU level do not appear to be addressed by EUfunded
research projects focusing on quality strategies and performance at hospital level
(Methods of Assessing Response to Quality Improvement Strategies (MARQuIS),
Deepening our Understanding of Quality Improvement in Europe (DUQuE), or the
European Network on Patient Safety (EUNeTPaS)). Patients’ rights and medication
safety are not directly addressed in the European Council recommendation on
patient safety, including the prevention and control of HAIs (2), nor in the European
Parliament and Council directive on the application of patients’ rights in cross-border
health care (3). The EU questionnaire on the transposition by Member States of
measures in the directive relates mainly to the mutual recognition of prescriptions and
refers to the legislation and not to medication safety and patients’ rights per se.
The two initiatives in which the National Centre for Quality Assurance was involved
– the MARQuIS and EUNeTPaS projects – explored the hospital level. MARQuIS
included patient interviews in three countries but, due to the project focus, questions
related mostly to the quality and organization of care provided for foreign patients and
did not refer to medication practices. The EUNeTPaS project provided a compendium
outlining the implementation of “good medication safety practices in Europe”.
The DUQuE project addressed the problem of patient responsibility in managing their
own health care through a patient experience survey for those admitted with acute
myocardial infarction, hip fracture, stroke and in labour (childbirth). It interrogated
understanding of the reasons for taking each medication and investigated whether
the patient needed to receive help on reading instructions, pamphlets or other written
material from the doctor or pharmacy.
Research related to patient and family involvement in the safety of their own care
– which results in evidence that patient empowerment is a factor that contributes to
safer care and less harm – is growing continuously, although it is not yet as extensive
in central and eastern Europe as elsewhere. Even less visible are presentations of the
needs and expectations and/or rights related to patients’ and families’ empowerment
in medication practices at PHC level, including patients’ and providers’ views of safe