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Why are patients not more involved in their own safety? A questionnaire-based survey in a multi-ethnic North London hospital population
  1. Wai Yoong1,2,
  2. Zouina Assassi3,
  3. Iman Ahmedani3,
  4. Rahma Abdinasir2,
  5. Max Denning2,
  6. Harriet Taylor2,
  7. Danya Chandrakumar2,
  8. Michael Kwakye3,
  9. Maud Nauta4
  1. 1 Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
  2. 2 Department of Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK
  3. 3 Medical Students, University College London Medical School, London, UK
  4. 4 General Practitioner, Camden Health Improvement Practice (CHIP), London, UK
  1. Correspondence to Dr Wai Yoong, Department of Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London N18 1QX, UK; waiyoong{at}


Purpose Active patient participation in safety pathways has demonstrated benefits in reducing preventable errors, especially in relation to hand hygiene and surgical site marking. The authors sought to examine patient participation in a range of safety-related behaviours as well as factors that influence this, such as gender, education, age and language.

Design A 20-point questionnaire was employed in a London teaching hospital to explore safety-related behaviours, particularly assessing patient’s willingness to challenge healthcare professionals and engagement in taking an active role in their own care while in hospital. Data was also collected on participant demographic details including gender, age, ethnicity, English language proficiency and education status.

Results 85% of the 175 patients surveyed would consider bringing a list of their medications to hospital, but only 60% would bring a list of previous surgeries. Only 45% would actively engage in the WHO Safer Surgery Checklist and over three quarters (80%) would not challenge doctors and nurses regarding hand hygiene, believing that they would cause offence. Female patients who had tertiary education, were fluent in English and less than 60 years of age were statistically more likely to feel responsible for their own safety and take an active role in safety-related behaviour while in hospital (p<0.05).

Conclusions Many patients are not engaged in safety-related behaviour and do not challenge healthcare professionals on safety issues. Older male patients who were not tertiary educated or fluent in English need to be empowered to take an active role in such behaviour. Further research is required to investigate how to achieve this.

  • patient engagement
  • safety-related behaviours
  • authority gradient
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  • Contributors WY initiated and supervised the project, performed literature search, designed tables and figures and wrote the manuscript. ZA and IA co-wrote the manuscript. RA performed literature search, designed figures and collected and analysed the data from the survey. MD co-wrote the manuscript. HT and DC performed survey data collection. MK and MN co-wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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