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To develop a total systems approach to advance patient safety, health care organizations must commit to fully engaging patients and families in every aspect of care at all levels.
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Engaging Patients and Families in Safety: Recommendations, Resources, and Case Examples

By IHI Team | Wednesday, February 24, 2021
Engaging Patients and Families in Safety
Photo by Jamie Street | Unsplash

In September 2020, the Institute for Healthcare Improvement (IHI)-convened National Steering Committee for Patient Safety (NSC) announced the release of Safer Together: A National Action Plan to Advance Patient Safety. This report draws from evidence-based practices, widely known and effective interventions, exemplar case examples, and newer innovations.

The National Action Plan prioritizes the following four foundational — and interdependent — areas for developing a total systems approach to accelerate and sustain improvement in patient safety:

  • Culture, Leadership, and Governance
  • Patient and Family Engagement
  • Workforce Safety
  • Learning System

The following excerpt (adapted from the Implementation Resource Guide: A National Action Plan to Advance Patient Safety) focuses on patient and family engagement. 

To develop a total systems approach to advance patient safety, health care organizations must commit to the goal of fully engaging patients, families, and care partners in all aspects of care at all levels. To do this, the Safer Together: A National Action Plan to Advance Patient Safety makes the following recommendations:

  • Establish competencies for all health care professionals for the engagement of patients, families, and care partners. Health care leaders in all care settings must ensure that health care professionals are prepared to form equitable and effective partnerships with patients, families, and care partners. Implementation tactics include using effective communication and training tools, including:
  • Engage patients, families, and care partners in the co-production of care. Health care leaders and health care professionals need to fully engage with patients, families, and care partners in ongoing co-design and co-production of their care.
  • Include patients, families, and care partners in leadership, governance, and safety and improvement efforts. Health care leaders and governance bodies need to involve patients, families, and care partners from all backgrounds in health care oversight, design, and improvement, as well as harm reduction efforts.


  • Ensure equitable engagement for all patients, families, and care partners. To ensure the ongoing engagement of patients, families, and care partners in safety, health care leaders must actively and equitably partner with all patients, families, care partners, and relevant community organizations.
  • Promote a culture of trust and respect for patients, families, and care partners. Health care leaders must ensure that health care professionals and all personnel interact respectfully and transparently with patients, families, and care partners and with each other.

Consider these case examples as you strengthen your efforts to engage patients and families:

  • OpenNotes facilitates open and transparent communication in health care by encouraging clinicians to share their visit notes with patients. Studies on sharing visit notes with patients and families indicate that this kind of transparency increases patient engagement, strengthens patient-provider relationships, and enhances safety. The OpenNotes academic research and advocacy group is based at Beth Israel Deaconess Medical Center and Harvard Medical School and works with collaborators nationally and internationally. The team is supported entirely by federal and philanthropic grants and does not develop software or products for sale.
  • MedStar Health is a not-for-profit health care organization that oversees 120 sites, including ten hospitals in the Baltimore–Washington metropolitan area. To engage patients as partners, it has embedded Patient and Family Advisory Councils for Quality and Safety (PFACQS) at the system level, in every hospital, and in its medical groups. The PFACQS report to the Board of Directors Safety and Quality Committees in each hospital as well as at the system level.
  • Emory Healthcare consists of 11 hospitals and offers health care services across more than 250 provider locations in Georgia, including primary care and urgent care . Emory leaders have established a robust Patient and Family Advisor (PFA) program that serves to guide decisions regarding a wide range of quality, safety, and operational improvement initiatives. Requests for partnerships are managed by using a database to match PFA’s lived experiences, skills, and interests to relevant improvement initiatives.

For more details, download the Safer Together: A National Action Plan to Advance Patient Safety, Self-Assessment Tool, and Implementation Resource Guide.

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