Partners in Safety: A Multiphase Study of Care Partner Engagement in Patient Safety in the Hospital

Abstract

Background: Patient safety remains a global health system problem. The involvement of care partners (CPs), such as family members, has emerged as a safety strategy, as they can monitor for and take action to prevent harm; yet, extensive evidence in this regard is limited and is primarily based on the presumption of CPs’ physical presence. Hospital restrictions during the COVID-19 pandemic prevented CPs’ access, creating a unique opportunity to learn about the criticality of their role in safety promotion, including the aspect of physical presence. Objective: The overarching objective of this three-phase study was to advance knowledge about the patient safety engagement at the direct care level in the hospital of CPs of adult patients. Methodology and Methods: Phase One was a qualitative study using interviews to explore and describe the safety engagement experiences of CPs of adults admitted to hospital, wherein CP restrictions existed. Phase Two was a qualitative systematic review (JBI methodology) about CP engagement in patient safety from the perspectives of CPs, patients, and health professionals. Phase Three was a qualitative secondary analysis (QSA) (using Phase One and Two data) to examine the 5-Facet Framework for Patient Engagement in Patient Safety (5-FFPEPS) with a focus on CP involvement. Results: Phase One, based on 12 participants, resulted in three themes. Overall, CPs believe their hospital absence had negative consequences on safety, increasing their concerns for the safety of the patient. For Phase Two, there were five synthesized findings extracted from 16 categories and 77 findings. Generally, all three groups had positive experiences of CP engagement in safety, although CPs were exceptional in detailing its emotional impact. The QSA (Phase Three) identified six themes pertaining to CP engagement in safety, which aligned with and contributed additional elements to three facets of the 5-FFPEPS specific to CPs. Conclusions: CPs feel they have a role in promoting patient safety at the direct care level, even if it results in increased stress. They value being present with the patient during their admission, regular communication with HCPs, and their actioning of safety activities are influenced by HCPs' interactions.