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Perspectives on Patient and Family Engagement With Reduction in Harm

The Forgotten Voice

Schenk, Elizabeth C., PhD, MHI, RN-BC; Bryant, Ruth A., PhD, RN, CWOCN; Van Son, Catherine R., PhD, RN, ANEF; Odom-Maryon, Tamara, PhD

doi: 10.1097/NCQ.0000000000000333

Background: Despite continued efforts to improve safety in hospitals, hospital-acquired harm persists. Strategies have been identified to establish patient-centered care and improve patient engagement with care. However, the relationship of patient and family engagement to reduction of harm is not well understood, with limited findings available in current literature.

Purpose: This qualitative study explored the perceptions and attitudes of patients and family members and several clinical disciplines toward patient engagement in reducing preventable harm in hospitalized patients.

Methods: We conducted 8 focus groups at 2 nonprofit hospitals with several constituencies: patients/families, registered nurses, physician hospitalists, and pharmacists/physical therapists.

Results: Thematic analysis of transcripts revealed multiple themes from different perspectives, including: family presence increases safety, the hospital environment is intimidating, and communication is essential, but I am not being heard.

Conclusions: The rich data suggest a significant opportunity for reducing risk and harm by more actively engaging patients and families in the effort. Increasing patient acuity and complexity of care furthers the need for partnering with patients and families more intentionally for increased safety.

Providence St Joseph Health, Renton, Washington (Dr Schenk); College of Nursing, Washington State University, Spokane (Drs Schenk, Bryant, and Odom-Maryon); and College of Nursing, Washington State University, Vancouver (Dr Van Son).

Correspondence: Elizabeth C. Schenk, PhD, MHI, RN-BC, College of Nursing, Washington State University, 103 E Spokane Falls Blvd, Spokane, WA 99202 (

Funding for this study was provided in part through a grant from Sigma Theta Tau International.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: February 8, 2018.

Published ahead of print: June 8, 2018

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