Improving Safety: Engaging With Patients and Families Makes a Difference!

Following a brief review of the history and context for patient and family member involvement in healthcare safety improvements, a variety of tools and mechanisms for patient engagement will be offered along with specific examples from Patients for Patient Safety Canada (a patientled program of the Canadian Patient Safety Institute) to illustrate the impact of involving patients and family members in safety work.Barriers and facilitators to patient engagement in safety will also be examined. History and ContextPatient safety became an issue of deep concern in Canada when the Baker-Norton Adverse Events Study (Baker et al. 2004) was released a few years after the Institute of Medicine's published To Err Is Human, which established that medical error was between the fourth and eighth leading cause of preventable death in the United States (Kohn et al. 1999).It has now been 10 years since the World Health Organization (WHO) 1 made patient safety a priority in October 2004 and called on the healthcare community to welcome patients and their family members as partners in creating a safer system.The WHO's Patients for Patient Safety (PFPS) program stream was created to support this initiative and the following year, invited a small group of 21 patients and family members who had experienced harm from healthcare to a meeting in London, England.This is where The London Declaration 2 was conceived, and it continues to be used to underpin the commitment and aspirations of PFPS Champions around the world as they work to make the system safer.To become a PFPS Champion, candidates must attend a WHO-approved patient safety workshop, must endorse The London Declaration and must sign an agreement, signifying their willingness to work in collaboration with the health system and its providers.Today there are more than 300 WHO PFPS Champions 3 in more than 50 countries, including 43 in Canada, most of whom are also members of Patients for Patient Safety Canada (PFPSC), a patient-led program of the Canadian Patient Safety Institute (CPSI).The rationale for involving patients and family members in safety work is to recognize that the perspectives of patients and family members may often differ from those who work in the system and can be valuable in planning and implementing safety improvements that are truly patient-and family-centred. Strategies and ToolsOver the past decade, a great deal of work has been done to advance the involvement of patients and families in patient safety work both here in Canada and around the world.In the United States, for example, the Institute for Patient-and Family-Centered Care has developed a package of resources for health organizations wanting to advance patient engagement.This package includes a variety of specific strategies and tools tailored to specific healthcare settings including hospitals, primary care and other ambulatory settings.4 These materials are available for free downloading and provide useful guidance for getting started and expanding and sustaining the work.Other helpful resources are available from the Institute for Healthcare Improvement (IHI), Planetree and the Joint Commission. 5 In Canada, the CPSI has demonstrated a strong commitment to patient engagement since 2006 by providing staff support to help create and sustain PFPSC's volunteer network.CPSI also

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