Patients' willingness and ability to participate actively in the reduction of clinical errors: A systematic literature review
Abstract
This systematic review identifies the factors that both support and deter patients from being willing and able to participate actively in reducing clinical errors. Specifically, we add to our understanding of the safety culture in healthcare by engaging with the call for more focus on the relational and subjective factors which enable patients' participation (Iedema, Jorm, & Lum, 2009; Ovretveit, 2009). A systematic search of six databases, ten journals and seven healthcare organisations' web sites resulted in the identification of 2714 studies of which 68 were included in the review. These studies investigated initiatives involving patients in safety or studies of patients' perspectives of being actively involved in the safety of their care. The factors explored varied considerably depending on the scope, setting and context of the study. Using thematic analysis we synthesized the data to build an explanation of why, when and how patients are likely to engage actively in helping to reduce clinical errors. The findings show that the main factors for engaging patients in their own safety can be summarised in four categories: illness; individual cognitive characteristics; the clinician-patient relationship; and organisational factors. We conclude that illness and patients' perceptions of their role and status as subordinate to that of clinicians are the most important barriers to their involvement in error reduction. In sum, patients' fear of being labelled "difficult" and a consequent desire for clinicians' approbation may cause them to assume a passive role as a means of actively protecting their personal safety.
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- Authors
- Doherty, C., & Stavropoulou, C.
- Affiliations
- University of Surrey (GB)
- Corresponding author
- Doherty, Carole
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 75
- Issue
- 2
- Pages
- 257-263
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2113639350
- Cited by
- 170
- References
- 86
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 12 · 2023: 10 · 2022: 16 · 2021: 19 · 2020: 13 · 2019: 23 · 2018: 10 · 2017: 15 · 2016: 10 · 2015: 5 · 2014: 12 · 2013: 10 · 2012: 1
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- patient participation, medical errors, patient safety, safety culture, clinician-patient relationship, barriers to patient involvement, illness, patient passivity, organizational factors, patient perspectives
- MeSH terms
- Humans, Mental Health, Patient Acceptance of Health Care, Patient Participation, Professional-Patient Relations, Socioeconomic Factors, Medical Errors, Patient Safety
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