Qualitative Comparison of Perceptions Regarding Patient Engagement for Patient Safety by Physicians, Nurses, and Patients

Abstract

Purpose

Patient engagement in ensuring patient safety is widely acknowledged, there is still a need to explore how perceptions of patient engagement vary among different stakeholders within the healthcare system. We aimed to compare the perceptions regarding patient engagement for patient safety among physicians, nurses, and patients by exploring the perspectives.

Patients and Methods

A qualitative study, comprising three focus group discussions (six to eight people each), was conducted in South Korea. Physicians and nurses who worked at the general hospital level or higher, and patients who had been hospitalized for more than 24 hours, were included. Researchers analyzed the transcripts, and a content analysis was performed to describe influencing elements of patient engagement for patient safety. A word cloud was created through keyword analysis of the transcripts.

Results

Based on 479 coded data, three categories and eight sub-categories were derived. The first moment of patient engagement was viewed as the choice of medical institutions. Reputation occupied a large part in the hospital selection for all participants, but they did not know about or use the national hospital evaluation data. Participants said that continuous patient engagement, such as the patient’s active questioning attitude, guardian’s cooperation, sufficient medical personnel, and patient safety education was required during treatment. However, it was said that patient engagement was ignored after patient safety incidents occurred. They mentioned that they were emotional and busy arguing for their own positions, and that it was difficult to use a medical dispute resolution method in practice. In the word cloud by group, fall, explanation, hospital, and patient were common words.

Conclusion

All three groups agreed on the importance of patient engagement for patient safety but differed in its influencing factors. Efforts should be made to reduce the difference between the three groups on how to involve patients for patient safety.

Plain Language Summary

To what extent can patient engagement for patient safety be expanded?

In this study, we confirmed the diverse perceptions of patients and medical personnel regarding patient engagement for patient safety. Physicians, nurses, and patients all answered that they did not generally know about the objective medical institutions evaluation data provided by the national, and said that when choosing a medical institution, patients depended on information from their reputation, social media, and web site search. During treatment, both patients and medical personnel expressed their hopes for active and independent engagement from patients, but also expressed the difficulty of requesting cooperation in engagement and difficulties in education. After the patient safety incident, both patients and medical personnel were emotional and occupied in asserting their respective positions, and they complained about difficulties in resolving medical disputes that are difficult to use in practice.

Keywords:

• patient participation
• patient safety
• focus groups
• health personnel

Data Sharing Statement

The datasets are not publicly available as no consent was sought from participants to allow sharing of data with third parties.

Acknowledgments

This article is revised version of Seung Gyeong Jang’s doctoral dissertation (2019, Yonsei University). We thank the participants for their participation in the study.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work is supported by the Ulsan University Hospital in 2018. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.