Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety

Bronwyn Newman; Kathryn Joseph; Ashfaq Chauhan; Holly Seale; Jiadai Li; Elizabeth Manias; Merrilyn Walton; Stephen Mears; Benjamin Jones; Reema Harrison

doi:10.1111/hex.13343

Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety

Health Expect. 2021 Dec;24(6):1905-1923. doi: 10.1111/hex.13343. Epub 2021 Aug 25.

Authors

Affiliations

¹ Centre for Health Systems and Safety Research (CHSSR), Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
² School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Australia.
³ Faculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
⁴ School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
⁵ Hunter New England Health Libraries, John Hunter Hospital, HRMC, Newcastle, New South Wales, Australia.

Abstract

Background: Patients are increasingly being asked for feedback about their healthcare and treatment, including safety, despite little evidence to support this trend. This review identifies the strategies used to engage patients in safety during direct care, explores who is engaged and determines the mechanisms that impact effectiveness.

Methods: A systematic review was performed of seven databases (CINAHL, Cochrane, Cochrane-Central, Embase, ISI Web of Science, Medline, PsycINFO) that included research published between 2010 and 2020 focused on patient engagement interventions to increase safety during direct care and reported using PRISMA. All research designs were eligible; two reviewers applied criteria independently to determine eligibility and quality. A narrative review and realist synthesis were conducted.

Results: Twenty-six papers reporting on twenty-seven patient engagement strategies were included and classified as consultation (9), involvement (7) and partnership (11). The definitions of 'patient engagement' varied, and we found limited details about participant characteristics or interactions between people utilizing strategies. Collaborative strategy development, a user-friendly design, proactive messaging and agency sponsorship were identified as mechanisms to improve engagement about safety at the point of direct care.

Conclusions: Agency sponsorship of collaboration between staff and patients is essential in the development and implementation of strategies to keep patients safe during direct care. Insufficient details about participant characteristics and patient-provider interactions limit recommendations for practice change. More needs to be learned about how patients are engaged in discussions about safety, particularly minority groups unable to engage with standard information.

Patient or public contribution: Review progress was reported to the CanEngage team, including the consumer steering group, to inform project priorities (PROSPERO CRD42020196453).

Keywords: patient engagement; patient participation; patient safety; point of care; systematic review.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Humans
Patient Participation*
Patient Safety*