The Neglected Role of Patients in Promoting Patient Safety

DEAR EDITOR

Providing safe and high-quality care has always been one of the main challenges for healthcare organizations and a fundamental concern for health systems, patients, and societies worldwide. At the international level, patient engagement has been recognized as a vital priority for promoting patient safety, and the World Alliance for Patient Safety has identified empowering and mobilizing patients as one of six actions in their Patients for Patient Safety program. ¹

In recent decades, patients’ role in health care has evolved. They are no longer merely passive recipients of services; instead, they have become active, empowered, and informed participants in the service delivery process. This transformative shift correlates with heightened patient engagement in promoting safety procedures and advocating for their well-being. ² Furthermore, the documents also show that today patients have the capacity and willingness to engage in safety promotion. Patient participation in healthcare services is not only considered as a legal right for the patient but also defined as an international standard for health care systems. ³

The term “patient engagement” refers to patient participation in health-related decision-making. However, some definitions also include patient involvement in care planning, delivery, monitoring, and evaluation as part of the scope of engagement. ⁴

In recent years, programs such as clinical governance, accreditation, and Patient Friendly Hospital initiatives have been implemented in the Islamic Republic of Iran to improve the quality and safety of hospital care and patient participation as one of the main standards is always in all these programs. Nevertheless, findings from various studies show that standards related to patient and public involvement in Iranian hospitals are weak. ^{1 , 5} In addition, patient engagement has often been neglected in providing primary health care in health centers. ⁶

Generally, despite existing laws and standards, the documentation of patient engagement in promoting patient safety in Iran’s health system is limited. As in many countries, in the Islamic Republic of Iran, patients’ lack of knowledge about their role, low level of health literacy, providers’ distrust of patients, socio-economic conditions, cultural beliefs, language and communication barriers, providers and patients’ reluctance, lack of time, resource limitations, and organizational culture are the most important obstacles to neglecting and forgetting the role of patients in promoting patient safety. ^{1 , 6}

Therefore, paying more attention to patient participation as the missing link in promoting patient safety in the Iranian health system is necessary. Ways to enhance patient engagement for improved patient safety commonly include raising awareness among patients and caregivers, involving patients in different stages of treatment, implementing proper patient identification systems, promoting a culture of patient safety in healthcare organizations, and facilitating effective communication between providers, patients, and companions. Additionally, consulting experts in patient safety and quality improvement and conducting research can help identify effective methods to increase the patients’ engagement in patient safety. Undoubtedly, recognizing patients as partners in care and achieving genuine patient participation will enable the patients to actively participate in and monitor their care and contribute to improving the quality and safety of services provided.

ACKNOWLEDGEMENT

Thanks to all the researchers, authorities and managers in the field of patient safety.

Conflict of Interest:

None declared.

References

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5. Chegini Z, Janati A, Babaie J, Pouraghaei M. Exploring the barriers to patient engagement in the delivery of safe care in Iranian hospitals: A qualitative study. Nursing Open. 2020; 7:457-65.
6. Chegini Z, Arab-Zozani M, Shariful Islam SM, et al. Barriers and facilitators to patient engagement in patient safety from patients and healthcare professionals’ perspectives: A systematic review and meta-synthesis. Nursing Forum. 2021; 56:938-49.