Encouraging patients to participate in their health care

AORN Journal,  June, 2007  by Suzanne C. Beyea

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At some time in their lives, most clinicians will find themselves in the role of a patient. After experiencing the health care system from this vantage point, many clinicians will acknowledge just how complex it really is. During these times, a clinician learns the importance of becoming a more participative and involved patient.

The ability to effectively negotiate the health care system is an important skill not only to learn but to be able to communicate to others. Clinicians need to be prepared to help their patients safely negotiate a clinical experience and the broader health care system. Regardless of the setting, patients who are involved in their own health care can be instrumental in preventing serious adverse events.

For example, imagine that you are a patient with an allergy to penicillin. The preoperative nurse informs you that you will receive a preoperative antibiotic. As the patient, you would want to be certain that the antibiotic is not penicillin or any of its derivatives. Asking questions about the antibiotic and alerting the nurse to your history of allergies is essential to maintaining your safety. From this example, it is apparent that a patient can become a crucial partner in ensuring his or her safety. Sharing pertinent history, seeking clarification of explanations, and asking questions about care processes are good beginning points for a patient's participation in his or her health care.

PATIENT INVOLVEMENT RESOURCES

Encouraging active participation of patients in their own health care is an important strategy in a patient-safety campaign. A number of key stakeholders in patient-safety initiatives, including the Agency for Healthcare Research and Quality (AHRQ), the Joint Commission, and the National Patient Safety Foundation (NPSF), have promoted the premise that if patients become more involved in their health care, patient safety will be enhanced. (1-3) These organizations have developed resources to support clinicians in their efforts to involve patients in their own health care.

The AHRQ campaign. Questions Are the Answer: Get More Involved With Your Health Care (1) is a public service announcement campaign that was developed to encourage patients to ask questions about their health care. The campaign includes television, radio, print, and web advertisements, which direct patients either to call a toll-free number (ie, [800] 931-AHRQ) or to visit the AHRQ web site at http:// www.ahrq.gov/questions aretheanswer. This comprehensive web site includes a number of resources for patients that provide guidance about preventing medical errors and getting more involved in their health care.

A helpful feature on this web site is the "question builder," which patients or family members can use to develop a list of questions to take to their health care providers during medical appointments. A patient can create a list of questions pertinent to his or her situation using any of the 70 specific questions or the 10 key questions that are provided on the web site.

Perioperative clinicians easily could provide patients with a list of these important questions to ask before they have surgery. These questions may help patients understand the risks inherent in surgery as well as various treatment alternatives available to them. For example, patients are encouraged to ask questions about

* why they need the surgical procedure,

* available alternative treatments, and

* the risks and benefits associated with the surgical procedure.

Additionally, the AHRQ web site includes numerous tips on how a patient can get more involved in his or her health care. There are resources on various topics including:

* reducing medical mistakes,

* talking with your clinician,

* reducing medical test mistakes,

* planning for surgery, and

* filling a prescription.

The web site also provides a number of links to other patient safety resources.

The Joint Commission. Another helpful resource to support patient involvement in health care was developed by the Joint Commission in conjunction with the Centers for Medicare and Medicaid Services. These resources are provided as part of the jointly sponsored Speak Up Campaign, (2) which was launched in early 2002. The intent of this campaign is to

   urge patients to take a
   role in preventing health
   care errors by becoming
   active, involved, and informed
   participants on
   the health care team. (2)

The Speak Up Campaign is composed of a number of initiatives designed for patients to help

* ensure that the correct procedure is performed on the correct site,

* prevent infections,

* avoid medication mistakes, and

* prevent mistakes associated with medical tests.

The Joint Commission provides a variety of Speak Up materials that do not require reprinting permission, making it easy for health care organizations to access, use, and distribute these materials. The web site has brochures, posters, and videos available for download. Some materials also are available in Spanish translations. (4)