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Patients’ willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review

Doherty, C and Stavropoulou, C (2012) Patients’ willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review Social Science & Medicine, 75 (2). 257 - 263. ISSN 0277-9536

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Abstract

This systematic review identifies the factors that both support and deter patients from being willing and able to participate actively in reducing clinical errors. Specifically, we add to our understanding of the safety culture in healthcare by engaging with the call for more focus on the relational and subjective factors which enable patients’ participation ( [Iedema et al., 2009] and [Ovretveit, 2009]). A systematic search of six databases, ten journals and seven healthcare organisations’ web sites resulted in the identification of 2714 studies of which 68 were included in the review. These studies investigated initiatives involving patients in safety or studies of patients’ perspectives of being actively involved in the safety of their care. The factors explored varied considerably depending on the scope, setting and context of the study. Using thematic analysis we synthesized the data to build an explanation of why, when and how patients are likely to engage actively in helping to reduce clinical errors. The findings show that the main factors for engaging patients in their own safety can be summarised in four categories: illness; individual cognitive characteristics; the clinician-patient relationship; and organisational factors. We conclude that illness and patients’ perceptions of their role and status as subordinate to that of clinicians are the most important barriers to their involvement in error reduction. In sum, patients’ fear of being labelled “difficult” and a consequent desire for clinicians’ approbation may cause them to assume a passive role as a means of actively protecting their personal safety.

Item Type: Article
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Social Science & Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Social Science & Medicine, 75(2), July 2012, DOI 10.1016/j.socscimed.2012.02.056.
Depositing User: Symplectic Elements
Date Deposited: 27 Apr 2012 13:24
Last Modified: 23 Sep 2013 19:23
URI: http://epubs.surrey.ac.uk/id/eprint/505310

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