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New Research Identifies Why Patients and Families are Uncomfortable Sharing Concerns and Asking Questions

August 08, 2018

A BMJ Quality & Safety survey reveals why some patients and family members do not speak up to their physicians and other members of their medical team when they have concerns or questions.

The research, conducted from July 2014 through February 2015, included 105 families of patients in the intensive care unit (ICU) at the time. In addition, a larger number of individuals (1,050) across the nation who had previously been in an ICU and their families also were surveyed through Qualtrics, an Internet survey company.

The results indicate:

  • Overall, 50 to 70 percent of family members were hesitant to voice their concerns about a loved one’s care in the ICU
  • Only half of survey respondents (52%) felt very comfortable asking medical staff for more information about a medical procedure or expressing concerns about a possible medical error (46%)
  • The most frequently cited reasons for not speaking up were not wanting to be considered a “troublemaker” by hospital staff (34%); not knowing who to talk with or how to voice their concern (32%); and thinking hospital staff was “too busy” to hear their concerns or questions (32%)
  • Those least likely to speak up were younger people, men, and those without personal experience with medical care

Researchers highlighted the need to better support and empower patients and family members to speak up about perceived errors, safety concerns, or other issues involving a patient’s care. Including patients and families as engaged members of a medical care team is a critical step in promoting a hospital’s culture of safety.

HAP this month is celebrating five years of leadership around health care’s focus on patient and family engagement, now referred to as person and family engagement (PFE). During August 2013, HAP established the first state hospital association-sponsored Personal and Family Advisory Council, supporting progress in Pennsylvania hospital performance on the Centers for Medicare & Medicaid Services’ PFE metrics.

For more information about HAP’s PFE efforts, please contact Janette Bisbee, HAP project manager.

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