Identifying patient safety issues – who does it better, staff or patients?

The safety of health care is now a major global concern.  It is likely that millions of people suffer disabling injuries or death directly related to medical care. As a result, there has been much written about the importance of patient safety culture across health organisations, accompanied by high levels of investment around staff training. Patient safety culture is defined as the attitudes, perceptions, and values that staff share within an organisation related to patient safety.

However, can we assume that staff training to improve safety culture is the best way forward?

The prestigious London School of Economics (through the Department of Psychological and Behavioural Science) recently published a seminal piece of research that addresses this question. Their research is titled:

Online patient feedback as a safety valve: An automated language analysis of unnoticed and unresolved safety incidents. You can read more about the article here https://onlinelibrary.wiley.com/doi/10.1111/risa.14002

This research analysed over 146,000 stories on Care Opinion using an automated machine-learning approach. The stories involved several hundred health services across the UK. Two key findings were:

• automated analysis can reliably detect patient safety issues reported by patients
• online patient safety concerns, rather than staff reported concerns, are associated with hospital level mortality

What was very surprising was the second point – that patients, through a safe, moderated, anonymous online platform, were better than staff at detecting safety issues related to mortality.

The paper concludes: "Augmenting staff reports with patient reports may be especially valuable when there is uncertainty about staff reporting. In such contexts, patients reporting freely online (e.g., anonymously, without consequence) may act as a safety valve, revealing safety incidents that have been unnoticed or unresolved."

This important piece of research provides sound evidence that health organisations would do well to consider investing in public online feedback to support their patient safety culture.  

Such feedback should be anonymous and moderated for the safety of patients and staff.