Lessons Learned from a Systems Approach to Engaging Patients and Families in Patient Safety Transformation

Abstract

Background: Effective patient-and family-centered care requires a dedication to engaging patients and family members in health system redesign to improve the quality, safety, and experience of care. Provided here are lessons learned six years after establishing an infrastructure of patient and family advisory councils (PFACs) focused on improving health care quality and safety.Context: A large regional health care system with multiple hospitals and ambulatory care delivery sites in the eastern United States adopted a systemwide approach to Patient and Family Advisory Councils on Quality and Safety (PFACQS R ) in 2012.Approach: This conceptual article describes the barriers and facilitators of adopting, implementing, and sustaining the PFACQS model across a large, geographically diffuse health system. Successful strategies that emerged include active board engagement, co-creation and mentorship by experienced patient advocates to support enhanced engagement by local PFACQS community members, and clear alignment with and line of sight on organizational quality and safety goals.Conclusion: Implementing a robust network of PFACQS focused on improving quality and patient safety requires leadership commitment to transparency, as well as mutual respect and trust. Establishing clear guidelines, structures, and processes supports early adoption. Openness to continuous improvement and adaptations are important to program success and contribute to program sustainability.

Sustaining improvement of hospital-wide initiative for patient safety and quality: a systematic scoping review

“…Successful hospitals endeavoured to embed the intervention in their culture by ensuring ongoing use 76 as a new norm, 79 including it in staff on-boarding 76 and consistently showcasing rewards. 81 Conversely, a lack of alignment with organisational priorities, 76 and conflicts with existing priorities, 77 standards 78 and policies 84 were barriers. Successful hospitals extended the change to building learning communities 85 and improvement expertise, 82 supporting local champions 77 at an organisational level.…”

“… 81 Conversely, a lack of alignment with organisational priorities, 76 and conflicts with existing priorities, 77 standards 78 and policies 84 were barriers. Successful hospitals extended the change to building learning communities 85 and improvement expertise, 82 supporting local champions 77 at an organisational level.…”

Quality and Safety Education for Nurses: Making progress in patient safety, learning from COVID-19

“…The first US national patient safety plan [ 17 ] cites areas of organizational progress. These include working interprofessionally for improved collaboration in patient care [ 18 ], more transparent reporting systems to capture near misses and adverse events [ 19 ], more integration of quality and safety competencies across health professions education, and strategic efforts to actively enlist patients in their care [ 20 ]. Yet, preventable harm remains pervasive.…”

“…Creating a safety culture that embraces transparency enables the organization, whether, in-patient or out-patient primary care, to learn from, not hide, near misses and preventable harm. Just Culture encourages learning from near misses and adverse events through a reporting system with systematic analysis, emphasizing accountability not individual blame [ 19 , 20 ].…”

Commentary: Leadership and a True Culture of Patient Safety

“…Best practices now include building advisory councils focused on quality and safety, ensuring that users of care serve on our governing boards, and engaging community members in our improvement committees and safety event investigation analyses. 7 Simultaneous with the early work at UIMC that became CANDOR, we engaged family members who had suffered tragic loss to serve on our event review committee. It was transformative.…”