Involving patients in patient safety

Twenty years ago, Vincent and Coulter published a paper (cited 566 times) entitled ‘Patient Safety: What about the patient’.

Many discoveries followed this important paper. Research by our team demonstrated that patients were sometimes reluctant to be involved in safety, particularly when this meant challenging a healthcare professional and especially when this person was a doctor. We have discovered that the level of involvement of patients depends on a range of personal factors (e.g. older people may be more reluctant) and that the level of involvement is associated with their impression of how well received this will be.
Many patients strive to be a ‘good patient’ as they think that the quality of care they receive is linked to how well liked they are by the team caring for them. Evidence that not all patients want to be involved in their care all of the time and that there are many barriers to involvement has revolutionised thinking, policy and practice regarding patient involvement.

Our research exploring the different ways patients can be involved in safety has been world leading. We found that most patients are willing to provide feedback on the safety of their care and that this information can be used to improve care. Within this programme (funded by NIHR) we developed a Patient Measure of Safety (PMOS) and collected data from over 2,400 patients on safety concerns. In a large randomised controlled trial, we were able to demonstrate that patients can provide valuable feedback about safety in an inpatient setting and that when this feedback is used by teams they were able to make improvements to safety. These tools are now used internationally (14 countries, 17 publications describing use) for research and service improvement).

This work led to an understanding that by improving the experience of patients, safety followed. With external funding from NIHR, we co-designed a patient experience toolkit with six clinical teams and patient volunteers. We worked with the ward teams and patient volunteers to implement the intervention and improve care. The learning from this action research process informed revisions to the toolkit which is now used regionally and nationally to improve care and is being rolled out via a coaches network. More information about the Yorkshire Patient Experience Toolkit (PET) can be found here.

We will continue to build on this work within this YH-PSRC.


O’Hara and Lawton (2016)
Lawton et al., (2017)
O’Hara et al., (2018)