Patient experience in co-production of care: perceptions about patient safety protocols.

Diovane Ghignatti Da Costa,Simone Silveira Pasin,Francis Ghignatti Da Costa,Gisela Maria Schebella Souto De Moura,Ana Maria Müller De Magalhães

doi:10.1590/1518-8345.3352.3272

Abstract

Objective:to analyze the experience of the patient during hospitalization, focusing on the co-production of care related to patient safety protocols.Method:qualitative study, whose data were collected through the triangulation of multiple sources: document analysis, observation of 10 professionals in the provision of care and 24 interviews with patient-families from 12 clinical and surgical inpatient units of a hospital. Thematic analysis was carried out, based on the concept of co-production.Results:safety protocols according to the experience of the patient portrayed the role of patient-families as co-producers of safe care. It was found an alignment between perceptions of the patients, institutional definitions and basic national and international patient safety protocols. However, these protocols are not always followed by professionals.Conclusion:co-production was perceived in the protocols for safe surgery and prevention of injuries resulting from falls. In patient identification, hand hygiene and medication process, it was found that co-production depends on the proactive behavior of patient-families, as it is not encouraged by professionals. The research contributes with subsidies to leverage the participation of the patient as an agent of their safety, highlighting the co-production of health care as a valuable resource for advancing patient safety.

Highlights

For more than a decade, the World Health Organization (WHO) has warned of the need to promote safer practices in the healthcare environment
Scope review about patient engagement in improving hospital services, shows that there is a lack of research on this theme, pointing to the need for future research with a behavioral focus on patient engagement(12). These findings from the foray into the literature mobilized the following research question: In the experience of the patient seen in hospitalization units, do perceptions emerge about the actions related to patient safety? The aim of the study was to analyze the experience of the patient during hospitalization, focusing on the co-production of care related to patient safety protocols
The results emerging from observation and interviews were grouped into three categories and in this study, the topics in the category of safety protocols were approached according to the experience of the patient: patient identification, safety in medication administration, care for the prevention of injuries resulting from falls, care for infection prevention with a focus on hand hygiene, consent process, safe surgery and care to prevent pressure injury

Summary

Introduction

For more than a decade, the World Health Organization (WHO) has warned of the need to promote safer practices in the healthcare environment. Considering the direction of health policies towards improvements in patient safety, through their participation, the focus of this research was on the experience of the patient in the co-production of care, from the perspective of quality in hospital service. The interrelation of the conceptual basis presented in this statement reflects the dynamic and interactive nature of the investigated object. Among the concepts, it is based on patient engagement in the assessment of health quality(3) and patient safety, consisting of reducing the risk of unnecessary damage associated with health care to an acceptable minimum(4). The concept of patient experience is emphasized, which involves interactions, organizational culture and patient perceptions throughout the continuum of care(5)

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Discussion

Conclusion