ArticleBMJ quality & safety2019
We want to know: patient comfort speaking up about breakdowns in care and patient experience.
Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Scoping review of patient and family engagement interventions in diagnosis: a paradox of too much, yet so little.BMJ quality & safety · 2026Article
- "Helpful in Thinking Through the Question": Redesigning the Patient Health Questionnaire-8 for Depression Assessment to Enhance Patient Engagement and Understanding.JMIR human factors · 2026Article
- Rehabilitation management for patients with spinal muscular atrophy: a review.Orphanet journal of rare diseases · 2025Review
- Management of care for hospitalized older persons - comfort as an essential outcome: a qualitative study.BMC nursing · 2025Article
- Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting.Frontiers in health services · 2024Article
- Patient experience of imaging reports: A systematic literature review.Ultrasound (Leeds, England) · 2023Review
- Unpacking the Cinderella black box of complex intervention development through the Partners at Care Transitions (PACT) programme of research.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Article
- Creating a Learning Health System for Improving Diagnostic Safety: Pragmatic Insights from US Health Care Organizations.Journal of general internal medicine · 2022Article
- Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.Infection control and hospital epidemiology · 2022Article
- Improving hospital safety for patients with chronic kidney disease: a mixed methods study.BMC nephrology · 2021Article
- Speaking up about patient-perceived serious visit note errors: Patient and family experiences and recommendations.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Patients and relatives as auditors of safe practices in oncology and hematology day hospitals.BMC health services research · 2021Article
- How Communication "Failed" or "Saved the Day": Counterfactual Accounts of Medical Errors.Journal of patient experience · 2020Article
- Development and Validation of WeCares, a Survey Instrument to Assess Hospitalized Patients' and Family Members' "Willingness to Engage in Your Care and Safety".Joint Commission journal on quality and patient safety · 2020Article
- Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes.JAMA network open · 2020Article
- Communicating with patients about breakdowns in care: a national randomised vignette-based survey.BMJ quality & safety · 2020Article
- Mixed-method investigation of health consumers' perception and experience of participation in patient safety activities.BMJ open · 2020Article
- Informatics opportunities to involve patients in hospital safety: a conceptual model.Journal of the American Medical Informatics Association : JAMIA · 2020Article
- The I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: a clinimetric evaluation.BMJ open · 2020Article
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up.
designCross-sectional study.
settingEight hospitals in Maryland and Washington, District of Columbia.
participantsPatients hospitalised at any one of eight hospitals who completed the Hospital Consumer Assessment of Healthcare Providers and Systems survey postdischarge.
main outcome measuresResponse to the question 'How often did you feel comfortable speaking up if you had any problems in your care?' grouped as: (1)
resultsOf 10 212 patients who provided valid responses, 4958 (48.6%) indicated they had experienced a problem during hospitalisation. Of these, 1514 (30.5%) did not always feel comfortable speaking up. Predictors of having a problem during hospitalisation included age, health status and education level. Patients who were older, reported worse overall and mental health, were admitted via the Emergency Department and did not speak English at home were less likely to always feel comfortable speaking up. Patients who were not always comfortable speaking up provided lower ratings of nurse communication (47.8 vs 80.4; p<0.01), physician communication (57.2 vs 82.6; p<0.01) and overall hospital ratings (7.1 vs 8.7; p<0.01). They were significantly less likely to definitely recommend the hospital (36.7% vs 71.7 %; p<0.01) than patients who were always comfortable speaking up.
conclusionsPatients frequently experience problems in care during hospitalisation and many do not feel comfortable speaking up. Creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience. Such efforts should consider the impact of health literacy and mental health on patient engagement in patient-safety activities.
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