Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families

The strength of evidence supporting patient safety improvement through intervention varies. Our approach sought to triangulate evidence, wherever possible, from the peer-reviewed literature,^6,198,274 domain experts (patients, providers, practice staff/leaders, policy and research experts), and a robust grey literature search. Our findings indicate a lack of strong evidence of the effectiveness of patient and family engagement strategies on improving patient safety in primary care settings. Much of the work identified draws on expert panel recommendations, technical expert panel reports, and well-described case studies of interventions. Large-scale demonstration projects in the field have not yet emerged for many of the recommended practices.

Our review depended heavily on targeted searching of the grey literature through Web sites, conference proceedings, and social media outlets to identify practices to improve patient safety. Many organizations used source documents, such as AHRQ's "Questions are the Answer"⁶³ or the National Patient Safety Foundation’s "Ask Me 3"²⁷⁵ program materials, and tailored them to their specific audiences' needs. Thus, while many tools are available, evidence on the usability and feasibility of implementing them in practice was limited.

We continue to receive emails on a near daily basis about new and emerging tools within the domains of patient safety, primary care, and patient engagement. Our plan is to review these interventions on an ongoing basis and incorporate the findings into Guide development.