Friday morning 4:00. I am on my way to airport to join a workshop on safer care at the hospital front door at the VU Medical Centre in Amsterdam. Alongside the A55 glowing in the dark over the sea the glowing points of the wind farms. Listening to the BBC World Service.
An interview with Declan Murphy, the Irish jockey, who cheated death after a serious head injury. From being a responsible and successful adult he is transformed into his 12 year old self with a complete loss of subsequent memories. A story of a long and complicated recovery, and the recognition, that “The only way I was going to not be a patient was to stop being treated like a patient” (http://www.bbc.co.uk/programmes/p04ygc2v). It struck me that this is probably a key part of improving hospital safety: if patients feel that they can only be passive and receivers of care, rather than being part of the care team, then they will have less influence on decision making around safety critical steps.
McKinsey sees this as a key challenge in the provision of future health care in achieving behaviour change, particularly in patients with chronic health problems (http://healthcare.mckinsey.com/sites/default/files/791750_Changing_Patient_Behavior_the_Next_Frontier_in_Healthcare_Value.pdf). Technology is mentioned as a possible tool but “change interventions are more likely to be successful if they take into account additional factors, such as a person’s behavioral profile or motivation to change.”
If we try to translate this into the role that patients currently play in their own safety in hospital then we need to probably understand better what would make patients want to change the status quo. And this might be different for those being admitted with life threatening emergencies then for those who attend for a scheduled routine procedure.
I am looking forward to hearing more about the ‘State of Patient Engagement’ later this months at the international forum for Quality & Safety in Healthcare (http://internationalforum.bmj.com/london/view-programme/). One of the speakers will be Ingrid Brindle. One of the areas what she has highlighted the importance of access to electronic records in one of her talks for the Kings Fund (https://www.kingsfund.org.uk/audio-video/ingrid-brindle-patient-perspective-shared-electronic-health-records).
Saturday evening: I am back from Amsterdam. Blistering sun-shine and the glistening sea on the way back to Anglesey. I have learnt more about determinants of safe hospital care from the CURIOS@study and a whole lot of new questions for the next two years of research with this European group.
What would motivate patients to take control of their safety in hospitals?