This presentation is elaborating the value of patient engagement and how to involve patients in maintaining their own safety

1. Patient Engagement
Dr. Mohamed Mosaad Hasan
MD, MPH, CPHQ, CPPS

2. OVERVIEW
• We are all consumers as patients and
family members – encourage thinking as
consumers
• We should all be active patient safety
advocates, as providers of services and
products, as well as consumers

3. LET’S BE RESPONSIBLE PROVIDERS OF
INFORMATION
• As patients, let’s know, document and
update our medical history, active
medications and our allergies.
• Understand that medication improper
usage, over-use, misuse and hand-off’s
are huge source of medication errors
worldwide.

4. SPEAK UP
Launched in 2002, The Joint Commission’s Speak
Up™ program urges patients to take an active
role in preventing health care errors.

5. SPEAK UP
• Speak up if you have questions or concerns. If you still
don’t understand, ask again. It’s your body and you have
a right to know.
• Pay attention to the care you get. Always make sure
you’re getting the right treatments and medicines by the
right health care professionals. Don’t assume anything.
• Educate yourself about your illness. Learn about the
medical tests you get, and your treatment plan.
• Ask a trusted family member or friend to be your
advocate (advisor or supporter).

6. SPEAK UP
• Know what medicines you take and why you take
them. Medicine errors are the most common
health care mistakes.
• Use a hospital, clinic, surgery center, or other type
of health care organization that has been carefully
checked out. For example, The Joint Commission
visits hospitals to see if they are meeting The Joint
Commission’s quality standards.
• Participate in all decisions about your treatment.
You are the center of the health care team.

8. • Don’t be intimidated.
– “Doctor, did you wash your hands?”
– Ask about anesthesia, IV drips, special tests,
x-rays with dyes, etc.
– Insist on full disclosure. We have a right to
know exactly what happens to our body.
“Nothing about me without me.”

12. LET’S BE EXPECTANT AND PRESUMPTUOUS
• Expect our privacy and confidentiality be
honored at all times
• Expect current, evidenced-based
medicine, unless logical and convincing
reasons for other approaches
• If a mistake happens without our
knowledge, even without harm, we
should be told -- ethical thing to do.

13. • What is the patient’s experience and
understanding of medical error?
• Can patients play a role in identifying
medical error and preventing harm?

14. Conditions for patients to prevent
medical errors
Ability to
behave safely
Ability to
communicate
errors
Ability to identify errors

15. Can patients identify and
communicate errors

16. • National telephone survey of 1,207
patients in 2002
• 42% of patients reported medical errors in
their own or a family member’s care
MDs “responsible” for most errors
Few disclosed error or apologized

17. • Design
 Med/surg patients at 16 Massachusetts
hospitals
• Sample
 2,582 (62%) completed a post-discharge
telephone survey
 998 also agreed to medical record review
Analysis
 MD panel classified reports

19. • In sum, many patients can identify
and report “safety” events.
• Some screening may be necessary.

20. Behaving Safely

23. Factors that Affect Patient Taking
Action
• Gravity of perceived threat.
• Preventability.
• Effectiveness of action.
• Consequences of speaking up.
• Self-efficacy.
• Staff members’ instructions and
expectations.

25. How Can We Promote
Engagement?

26. Condition (H) Help
• Condition Help (H) is a program that enables patients
and family members to call for immediate help if they feel
the patient is not receiving adequate medical attention.
• Modeled on the Rapid Response Team, a group of
clinicians available to rush to a patient’s bedside
whenever a nurse or other caregiver feels a patient’s
condition is deteriorating, UPMC’s Condition H gives
patients and families a way to alert a similar team who
will come and assess the situation

32. Questions
• How much can (and should) we rely on
patients to ensure their own safe care?
• Does patient participation signal a failure
of our systems to prevent or trap errors?
• Can we customize the approach for
different patients with different capacities?
• What safety behaviors (for patients) hold
the most promise?