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Advising Patients About Patient Safety: Current Initiatives Risk Shifting Responsibility

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Background: Many health care providers now disseminate advisories telling patients what they can do to avoid errors and harms in their care.

Methods: The content of five leading safety advisories for patients was analyzed and a critique of their development, content, and impact was developed, drawing on published literature and 40 interviews with a diverse sample of 50 key informants.

Findings: Very little is known about the effects of the distribution of safety advisories to patients, but several grounds for concern were identified. There was a lack of attention to patients' perspectives during the development of advisory messages, and the advisories say little about what health care providers should do to ensure patient safety. Patients are given little practical support to carry out the recommended actions, and health professionals' responses may render their attempts to act to secure their own safety ineffective. Some messages suggest an inappropriate shifting of responsibility onto patients. Advice that involves checking on or challenging health professionals' actions appears to be particularly problematic for patients. Such behaviors conflict with the expectations many people have—and think health professionals have—of patients' roles.

Discussion: A serious commitment to optimizing patients' contributions to safe care requires a researchbased understanding of patients' perspectives and more practical facilitation of patient involvement.

Document Type: Research Article

Publication date: 2005-09-01

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  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect ( For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit for more information. All other readers, please visit to subscribe to the journal or to claim your access for an existing subscription.
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