Involving patients in patient safety: is a co-designed multi-component intervention to involve patients and carers in patient safety feasible and acceptable?

Problem

Involving patients and carers in patient safety within primary care is a key international and national policy but how to do this in a way that is acceptable and feasible has remained underexplored. In principal working patients and carers should be active partners in patient safety with healthcare professionals and be empowered to use personalised approaches to identify safety concerns and work together to prevent them. The patient safety guide for primary care (PSG-PC) intervention was co-developed in partnership with patients, carers, GP and community pharmacists and aims to address key patient safety questions and identify key points where they can make their primary care interactions safer to be active partners in their care.

Approach

The PSG-PC is a multi-component intervention with a mobile application compatible with Android and Apple devices, paper booklet, and website. Using a 2 phase non-randomised feasibility mixed methods pragmatic study the acceptability and feasibility of the PSG-PC was evaluated. All patient and/or carer participants received the paper version of the PSG-PC and could download the mobile versions. The PSG-PC feasibility study explored the feasibility of recruiting and retaining participants with an intervention targeted at improving patient safety. Participants were recruited through primary care and the intervention and recruitment process were adapted to reflect the change in primary care due to COVID-19 restrictions. Participants were aged 18 years or older who attend appointments at general practice. It measured secondary outcomes for improving patient safety, health status, patient empowerment and reducing health service utilisation over 6 months. Data was collected via a postal or online survey. Semi-structured interviews were conducted with participants about their experiences of using the PSG-PC to examine acceptability of the intervention.

Findings

8 general practices were recruited over both phases and 132 patient and/or carer participants and 69%follow-up rate at 6 months. Participant’s reported using the PSG-PC from planning appointments to recording information post-consultation. The PSG-PC was able to be responsive and useable during changes in care provision because of COVID-19. Interviews participants described a continuum of involvement of preferences for their involvement in patient safety which influenced engagement with the PSG-PC and more broadly the concept of patient safety.

Consequences

Involving patients and carers in patient safety needs a tailored and personalised approach that enables patients and carers to use resources like the PSG-PC routinely and help challenge assumptions about their willingness and ability to be involved in patient safety.