Meeting with the Clinical Safety Research Unit and MRSA Action UK to discuss
Patient Involvement and Empowerment in the Provision of Safer Healthcare

Held at St Mary's Hospital, London

10th September 2007


Present:        Rachel E Davis, Research Associate

Derek Butler, Chair MRSA Action UK


MRSA Action UK were invited by the Clinical Safety Research Unit to participate in research relating to patient safety and patient involvement and empowerment. The focus of the research was on how patients can become involved in their own care and safety and how they can participate in decisions about the treatment they receive from doctors and consultants, with a particular focus on healthcare associated infection and minimising risk. A presentation was given by MRSA Action UK and a paper circulated, it was well received and it was agreed that this could be cited and used in the research.


MRSA Action UK emphasised that however much we want to involve patients and their families in the care they receive, and in the safety of that care, the underlying responsibility for the patients' care has to be that of the medical professional.  In saying this however, the patient can be a buffer to the errors that may occur in the treatment they receive if they are involved and engaged.


Discussion took place as to how we engage patients into the arena of healthcare and the part they have to play in helping to reduce the incidence of contracting infections in the healthcare setting, and ultimately in the community.


The medical profession have to come to understand that they have to change and adapt to advances in medical treatments, and as such they have to change the way that they and others who have responsibility for medical care of patients interact with those receiving it. This also has to change in the way that medical professionals talk to and communicate with the patient in giving them and their families information about the treatment they are receiving and the possible outcomes that may arise from such treatment including healthcare associated infections.


There would appear to be a misconception that patients do not want information about the treatment they receive and it may be believed that patients are too afraid to ask questions with regard to treatment for healthcare infections.


Studies have shown that in certain demographic areas this may be evident, and that in Europe it was the older age groups that were inclined to be less willing to participate in questioning doctors. In the USA however the opposite was the norm and in the healthcare system they had greater choice in receiving medical treatment and patients were more inclined to question.


This was also a driving factor with regard to healthcare infections in that patients wanted to know which hospitals were the "safest", that is those with the lower risk of acquiring an infection. This has become one of the biggest driving factors for hospitals in the USA to reduce their infection rates.


In the UK patients have not enjoyed that freedom of choice and therefore this driving factor is only now coming to the fore. Information needs to be easily available on hospital safety and healthcare infections, as things currently stand it is not easy for the layperson to obtain that information, we believe patient groups have a role to play in disseminating this type of information.


Discussion revolved around systems that were employed by hospitals in their everyday work. Hospitals needed to introduce and employ the latest thinking to ensure patient safety and good infection prevention and control. Staff needed to be educated in a different way of thinking, employing sound change management techniques so that they had an understanding of why they were being asked to interact with patients in the design of their care. The patients themselves had to be given information as to what was happening around them and needed confidence to be able to question medical staff about how they were being treated. For the very vulnerable and poorly patient this may not always be possible, and MRSA Action UK had made strong representation to the Department of Health on this issue.


Healthcare workers would need to view questioning with a different perspective and to accept challenge in a positive way. Patients and their relatives had to be given the confidence to ask by being invited in a manner that made them feel at ease with the medical team looking after them.


How can you make patients that are not naturally inclined to ask these types of questions to medical professionals become involved? There are many ways that patients and hospitals can overcome this barrier by iterative techniques both verbal and visual, that can serve as prompts to both doctor and patient.


In the respect to patient safety, what has usually happened is that everything has been reactive and not proactive. It was thought that this was an area that both the medical profession and organisations like ourselves could make headway in. With the hospitals it was believed that they had to be more open and honest with both patients and their families, and with the general public. There was a large area for improvement on this subject, and there could be a reluctance to do this because of the difficulties it may cause hospitals and staff. There was a requirement for a culture change and mind set for those used to working in a set pattern for so long. Healthcare workers need to feel comfortable about discussing the issue of hospital associated infections with patients and also need to be empowered by knowledge.


For our Charity we have already taken the first steps toward informing groups outside the normal arena of those already affected by healthcare infections in that we are in the process of giving presentations to all the stakeholders within the health economy. We agreed that this would be a proactive approach and that it would give future patients and carers some information and background into how to approach medical professionals and that to ask these questions should be the norm.


There was an historical background given about the Charity and the members. It was shown that we are an organisation with an enormous wealth of knowledge and experience, and that we are all committed to working with all the stakeholders in the campaign to reduce healthcare infections.


We were asked if we were prepared to give presentations to those that not only use the hospital, but also to the staff. Education and information is key to ensuring patient safety, be that from untoward incidents (medical mistakes) or from healthcare infections. What is quite clear is that everyone has a role to play in keeping patients safe and free from all avoidable healthcare infections, but the ultimate responsibility for patient care rests with those providing the care - the healthcare professional.

(c) Derek Butler

10 September 2007
MRSA Action UK