Mixed-method investigation of health consumers' perception and experience of participation in patient safety activities

What Factors Influence Patient Measures of Safety Among Adults?

Purpose

This study aimed to examine the level of patient measures of safety and identify the influencing factors of patient measures of safety among Korean.

Methods

This study was a cross-sectional study. From February 7 to February 12, 2024, data were collected through a structured on-line questionnaire consisting of items about general characteristics, patient safety knowledge, nurse-patient interaction, experience of patient participation, willingness to participate in patient safety, and patient measures of safety involving 330 adults. Since there were no incomplete responses, data from all 330 participants were included in the final analysis. The collected data were analyzed using descriptive statistics, t-test, chi-square test, analysis of variance, post-hoc test, correlational analysis, and regression analysis.

Results

Patient measures of safety showed significant positive correlations with patients' safety knowledge, nurse-patient interaction, patient experience in participating in safety activities, and patients' willingness to participate in safety activities. The employment status, nurse-patient interaction, patient experience in safety activities, and willingness to participate in safety activities were identified as significant factors affecting patient measures of safety.

Conclusion

Enhancing nurse-patient interaction-a crucial determinant of patient safety measures-would require implementing effective communication programs. Additionally, it is significant to facilitate patient expression of safety concerns and establish a patient-centered safety monitoring and feedback system. This would actively promote patient participation in safety activities.

Co-Creation in the Development of Digital Therapeutics: A Narrative Review

Digital therapeutics (DTx) are transforming healthcare delivery through personalised, evidence-based interventions that offer a cost-effective approach to health management. However, their widespread adoption faces significant barriers including privacy concerns, usability issues, and integration challenges within healthcare systems. This review assesses the current evidence on DTx, with a particular focus on the role of co-creation in enhancing design and usability. A narrative review was conducted to identify studies exploring co-creation in DTx development. Three studies were selected for in-depth analysis, demonstrating that co-creation processes significantly improve the usability and effectiveness of DTx interventions. Findings underscore challenges in DTx implementation, including complex regulatory processes, digital inequality, high development costs, and difficulties in integrating with existing healthcare systems. Despite the existence of discrete examples of co-creation in DTx and its acknowledged value in the healthcare domain, systematic research in this field remains markedly limited. Future studies should prioritise establishing best practises for co-creation, with particular emphasis on methods to enhance data privacy and security, standardisation protocols, and patient engagement strategies to optimise DTx adoption and effectiveness. This review contributes to the growing body of literature on DTx by highlighting the potential of co-creation while also identifying critical areas for future research.

Impact of hospital outpatients' experiences of patient safety on fear of infection: a secondary analysis of national data

INTRODUCTION

Amid the COVID-19 pandemic, outpatients' concerns about infection risk have increased. It is crucial to understand the factors that contribute to this fear of infection to promote patient safety and encourage outpatients to seek proper follow-up treatment without fear. This study aims to understand the relationship between outpatients' experiences of patient safety and their fear of infection.

DESIGN

This was a secondary analysis of national data from the Healthcare Service Experience Survey in 2020.

SETTING AND PARTICIPANTS

A total of 4416 patients with experience using outpatient services in the past year were included in South Korea.

PRIMARY AND SECONDARY OUTCOME MEASURES

Demographic characteristics, fear of infection and safety experiences were assessed in the original survey. Fear of infection served as the dependent variable, with safety experiences-specifically, patient identification, preinjection explanations, hand hygiene, proper use of injection supplies, skin disinfection and adverse drug reactions-as the independent variables.

RESULTS

Approximately 14% of outpatients had a fear of infection when receiving medical care. The unadjusted model showed that all patient safety categories were determinants of fear of infection, and the multivariate logistic model identified hand hygiene and medication safety experiences as significant factors associated with fear of infection.

CONCLUSIONS

This study revealed that patient safety experiences are associated with fear of infection in outpatient settings. Improving healthcare professionals' hand hygiene and managing adverse drug reactions are crucial for enhancing patient safety.

Perception gaps of patient engagement for patient safety between healthcare professionals and the public in Korea

BACKGROUND

To ensure effective patient engagement, patients' efforts, partnerships with healthcare professionals, and the organisation's role in providing safe healthcare settings must be emphasised. Perception gaps regarding patient engagement between the public and healthcare professionals could prevent healthy partnerships from forming and hinder patient engagement activities. This study examined healthcare professionals' perception of patient engagement and compared the findings with that determined for the public in a previous study.

METHODS

An anonymous online survey was conducted in February 2020 among 1,007 healthcare professionals (physicians, nurses). The questionnaire comprised five parts regarding the perception of patient engagement. Descriptive analysis and Chi-squared/Fisher's exact tests determined the frequency and significant differences among the public from previous study and healthcare professionals in this study.

RESULTS

The perception of the importance of patient safety was high among healthcare professionals and the public. However, statistically significant differences in perceptions were observed among the public and healthcare professionals in all categories. The perception gaps were substantial between the groups in sub-categories of engagement for patient safety during medical treatment; 86% of physicians and 90% of nurses agreed that patients participate in the decision-making for the treatment process. Conversely, 58% of the public agreed. Only 22% of the public agreed with confirming healthcare professionals' hand washing to prevent infection, versus 57% of physicians and 65% of nurses. More than 89% of healthcare professionals positively perceived medical dispute mediation versus only half of the public. In certain areas such as "medical dispute mediation and arbitration programs", "fall prevention", and "infection prevention", there was a statistically significant difference in the perception of patient involvement among healthcare professionals, with nurses' perception being particularly more positive than that of physicians.

CONCLUSIONS

The healthcare professionals' perception of patient engagement was more positive than that of the public. To narrow the perception gaps and enhance the public's perception, strategies involving changes in healthcare systems, promotional efforts, and educational initiatives should be developed. Additionally, strategies should be formulated for healthcare professionals to better engage as partners in patient care.

[Structural Topic Modeling Analysis of Patient Safety Interest among Health Consumers in Social Media]

PURPOSE

This study aimed to investigate healthcare consumers' interest in patient safety on social media using structural topic modeling (STM) and to identify changes in interest over time.

METHODS

Analyzing 105,727 posts from Naver news comments, blogs, internet cafés, and Twitter between 2010 and 2022, this study deployed a Python script for data collection and preprocessing. STM analysis was conducted using R, with the documents' publication years serving as metadata to trace the evolution of discussions on patient safety.

RESULTS

The analysis identified a total of 13 distinct topics, organized into three primary communities: (1) "Demand for systemic improvement of medical accidents," underscoring the need for legal and regulatory reform to enhance accountability; (2) "Efforts of the government and organizations for safety management," highlighting proactive risk mitigation strategies; and (3) "Medical accidents exposed in the media," reflecting widespread concerns over medical negligence and its repercussions. These findings indicate pervasive concerns regarding medical accountability and transparency among healthcare consumers.

CONCLUSION

The findings emphasize the importance of transparent healthcare policies and practices that openly address patient safety incidents. There is clear advocacy for policy reforms aimed at increasing the accountability and transparency of healthcare providers. Moreover, this study highlights the significance of educational and engagement initiatives involving healthcare consumers in fostering a culture of patient safety. Integrating consumer perspectives into patient safety strategies is crucial for developing a robust safety culture in healthcare.

Patients' Perception of Patient-Centered Care and Associated Factors Among Patients Admitted in Private and Public Hospitals: A Comparative Cross-Sectional Study

Introduction

The provision of patient-centered care is challenging around the globe, including in Ethiopia. There is a scarcity of information on this issue. Therefore, this study aimed to assess patients' perceptions of patient-centered care and associated factors among patients admitted to public and private hospitals in Bahir Dar city.

Methods

A facility-based comparative cross-sectional study was conducted from May 8-June 15, 2022. Using a multistage sampling approach, the study participants were selected. An interviewer was used to collect the data. Bi-variable and multivariable logistic regressions were used to analyze the data. Statistical significance was declared using a p value< 0.05.

Results

Overall, 53.7% of patients reported poor patient-centered care. And it was higher among public hospitals (66.3%) than private hospitals (40.3%). Length of stay (AOR = 4.2; 95% CI [1.1, 15.3] and AOR = 4.3; 95% CI [1.4, 13]), intimacy with providers (AOR = 2.4; 95% CI [1.2, 4.6] and AOR = 3.9; 95% CI [1.1-9.6]), privacy during care (AOR = 4.2; 95% CI [1.93, 8.9]and AOR=3.3;95% CI: [1.5-7]), easy access to service (AOR=2.76;95% CI [1.33, 5.74] and AOR=3.8;95% CI [1.15, 12.7]) were associated with patient-centered care in public and private hospitals respectively. Awareness of the disease (AOR = 2.3; 95% CI [1.12, 4.8]), information on plans of care (AOR = 4.6; 95% CI [1.9, 10]), and being involved in decisions (AOR = 2.7; 95% CI [1.28, 5.9]) were associated factors in private hospitals. The following factors were associated with the practice of patient-centered care only in public hospitals: residence (AOR = 2.9; 95% CI [1.4, 5.5]), medication information (AOR = 2.88; 95% CI [1.34, 6.2]), and external appearance of hospital (AOR = 2.27; 95% CI [1.04, 4.97]).

Conclusion

This study showed that the practice of patient-centered care in public hospitals was poor compared to that in private hospitals. Hence, hospitals should train their staff regarding a culture of patient-centered care in order to deliver high-quality and safer care.

The effects of a mobile application for patient participation to improve patient safety

Background

Patient participation in patient safety activities in care processes is a fundamental element of safer care. Patients play an important role in preventing patient safety incidents and improving health outcomes. Therefore, healthcare providers need to develop and provide educational materials and actionable tools for patient participation.

Objectives

This study aimed to develop a mobile application for health consumers' participation and evaluate the effect of the mobile application on improving health consumers' participation in patient safety.

Methods

A quasi‐experimental design was adopted. We developed a mobile application on the basis of a needs assessment, literature review, compilation of patient safety topics, and validity testing of the application. The target population included Korean adults aged between 30 and 65 years who had visited a medical institution more than once within the most recent 6 months. The intervention group received patient participation training by using the mobile application, Application for Patient Participation in Safety Enhancement, for 2 months. The primary outcome variables were patient safety knowledge, self‐efficacy of participation, willingness to participate and experience of patient participation in patient safety activities. End‐user satisfaction was assessed using a questionnaire. To assess participants' experiences with the intervention, qualitative data were collected through a focus group interview and open‐ended responses to an end‐user satisfaction survey.

Results

The intervention group (n = 60) had significantly higher overall average scores than the control group (n = 37) with regard to patient safety knowledge (p < .001), self‐efficacy of participation (p = .001), willingness to participate (p = .010) and experience of participation (p = .038) in the post‐survey. The total mean end‐user satisfaction score was 3.56 ± 0.60. The participants expressed the realization that patients could play an important role in improving patient safety.

Conclusions

This study demonstrated that educating health consumers through a mobile application with useful information improves patient participation in patient safety activities. Educational materials and patient participation tools could motivate health consumers' health‐related behaviours.

Patient or Public Contribution

Patients were involved during the programme development and evaluation.

You're Worried, We're Listening: Online Testing of the Effectiveness of Education Materials to Improve Consumer Knowledge and Confidence in Reporting Patient Deterioration

OBJECTIVES

Early identification of patient deterioration in hospital is important to reduce mortality, avoidable morbidity, length of stay, and associated healthcare costs. By closely observing physical and behavioral changes, deteriorating patients are more likely to be identified. Patients and family at the bedside can play an important role in reporting deterioration if made aware of how to do so. Therefore, the objective of this study was to undertake an online evaluation of educational materials designed to improve consumers' knowledge and confidence to report patient deterioration.

METHODS

A convenience sample was used to recruit community-based participants for an online survey. A self-designed validated instrument was used to undertake a preintervention and postintervention test involving 3 types of educational materials. Quantitative data were analyzed with Wilcoxon signed rank test to compare participants' knowledge and confidence before and after exposure to the intervention. Conventional content analyses examined responses on key messages and recommendations to improve the educational materials.

RESULTS

A total of 84 respondents completed both prequestionnaires and postquestionnaires. After exposure to the education materials, analyses confirmed that knowledge and confidence scores were significantly higher than baseline measures. Content analyses indicated a clear understanding of the key messages presented in the materials. Four main recommendations were made regarding the education materials.

CONCLUSIONS

Participants readily identified the key messages in the educational materials and demonstrated increased knowledge and confidence to report concerns about deterioration. Further research is required to determine the efficacy of the educational materials in relation to consumer behavior.