Developing a framework for patient engagement in patient safety in Iranian hospitals

Abstract

Abstract

Introduction: Health care inevitably associated with events that threaten patient safety. The world health organization’ recent approach to enhance patient safety is to engage patients as part of the treatment team which has received less attention in developing countries, especially in Iran. Objective: The purpose of this study was to develop a framework for patient engagement in patient safety in Iranian hospitals. Methods: This multi-method study conducted between 2017 and 2019 using various approaches such as systematic review, qualitative study including interview, expert panel and Delphi technique as well as action research. Initially, based on the findings of the systematic review and qualitative study, the factors that affecting patients’ participation in patient safety were identified. Then, the framework was developed and finalized through two Delphi rounds. Finally, this framework was implemented in Sina hospital and its impact on three indicators of hand hygiene, patients fall and pressure ulcers were evaluated. Results: Factors such as staff unwillingness, patients' unwillingness, and lack of adequate infrastructure prevent patients from participating in patient safety. The framework presented in this study consists of four main dimensions and 33 components. After the pilot implementation of framework, staff knowledge and attitudes toward hand hygiene, patients’ knowledge and self-efficacy in preventing falls and patients' participation in preventing pressure ulcers has been increased. Also, hand hygiene compliance increased. On the other hand, increasing the patients' knowledge had no significant effect on the likelihood of falling, but increasing their self-efficacy and participation reduced the likelihood of falling and the pressure injuries, respectively. Conclusion: Health care recipients can contribute to improving patient safety. The framework presented in this study is a proposed sulotion for involving patients in improving patient safety, therefore, it is recommended to use in health care delivery in Iranian hospitals.