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Communication Dans Un Congrès Année : 2011

Patient participation to patient safety in radiotherapy: Reality or Necessity?

Résumé

Context. Patient safety has become a central priority for public policy, as evidenced by the number of accidents reported in the media in recent years. In this context, the involvement of users / citizens to manage their own security may be a way of improvement. Participation can be defined as actions taken by patients to reduce the likelihood of medical errors and / or mitigate the effects of errors when they do occur (Davis, 2007). Although very few studies address this question (Vincent & Coulter, 2002), it responds to major current issues. On one hand, the number of cancer patients is increasing every year. It increases the risks associated with their care, and raises the question of the role patients (and their families) can play to reduce these risks. On the other hand, promoting patient active participation joins the objectives of the Law of March 4, 2002, and the wishes of the patients themselves who want to be more independent and more involved in decisions about their health (Coulter & Jenkinson, 2005). Objective. The study reported in this paper is conducted in the radiotherapy department of a Paris hospital. It aims (1) to analyze if patients are involved in the management of their own safety and if so, in what way, and (2) to describe the issues of patient involvement in healthcare safety. Method. The methodology used combines observations of the patient treatment chain and interviews with professionals who are in direct interaction with patients (radiation oncologists and radiographers), and with patients. Results. The results show that patients actually participate in the safety of their care. Two forms of patient involvement emerged: corrective actions and preventive actions. Corrective actions correspond to the report of errors or omissions made by health professionals of the treatment chain (oblivion of restraints, a beam untreated, mistaken identity, an error in the irradiation zone) or not (and the alerts medical errors by dispensing pharmacy). Preventive actions refer to the actions or information voluntarily provided by the patients and which act as barriers for patient safety. For example, some patients verify their identity without having been asked. Similarly, some patients report some information about their own clinical history which may have harmful outcomes (patient having already been irradiated in the past, patient having not completed chemotherapy, etc.). The results also show that patients can adopt risky behaviors. For example, some patients voluntarily take the place of another in order to be irradiated because they are tired of waiting. It raises the problem of patient education and the necessity to consider patient as actors of their own safety. Conclusion. The study allows understanding if and how patients can participate in the safety of care. It shows that participation is a reality insofar as patients actually participate in the safety of their own care. It also shows that patient participation is a necessity which still remains unrecognized. Yet it is a way to reduce both the number of risk situations and the number of risky behaviors of patients. These elements highlight the important role of therapeutic education of both patients and health professionals in order to achieve cooperative safety management.
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Dates et versions

hal-04224935 , version 1 (02-10-2023)

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  • HAL Id : hal-04224935 , version 1

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Adeline Pernet, Vanina Mollo. Patient participation to patient safety in radiotherapy: Reality or Necessity?. 3rd Healthcare systems Ergonomics and Patient Safety (HEPS) International Conference: “An alliance between professionals and citizens for patient safety and quality of life”, Jun 2011, Oviedo, Spain. ⟨hal-04224935⟩
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