“What one change improves hospital quality and patient safety the most?” I get some form of this question every time I describe my work with the Essential Hospitals Engagement Network to reduce hospital-acquired conditions.

Of course, there is no single change to a multifaceted care delivery setting that can guarantee improved patient safety. But in a world with limited resources, I understand wanting to which solution provides the biggest bang for the buck.

So how do I respond? I say patients can be more active partners in ensuring all precautions are taken to minimize the risk of harm, and that this depends on providers supporting an environment that fosters such partnerships. In other words, I am talking about patient and family engagement.

My response echoes this year’s Patient Safety Awareness Week (March 8-14) theme of “United in Safety.” From patients and families to clinicians and administrators, we all have a role in promoting patient and family engagement for safer care.

Growing Evidence for Patient and Family Engagement

A systematic review in 2010 on the effectiveness of interventions to promote patient involvement in patient safety found limited evidence connecting patient involvement to reductions in incidents of patient harm. But since 2010, more evidence has surfaced highlighting the positive impact of patient engagement.

One of the more recent studies, published this month in Health Affairs, looked at changes in patient activation levels relative to health outcomes and costs. The study found that as patients’ knowledge, skill, and confidence in managing their health care grew, clinical indicators associated with diabetes and heart disease improved alongside reduced emergency department visits.

How Hospitals Can Engage Patients and Family

Effective patient engagement is not a straightforward proposition for either the patient or the provider. I experienced firsthand, when I broke my jaw two years ago, how awkward it is to broach the subject of patient safety with clinicians, while trying not to undermine their knowledge and skill. I could tell some nurses were bewildered and a little annoyed that a scrawny guy in his 20s was concerned about pressure ulcers. Fortunately, there are practical guidelines on how health care providers can support patient involvement in patient safety.

Here are some tips mentioned in a systematic review published this month on patient participation in patient safety, along with related examples from essential hospitals:

While patient and family engagement is my short answer to the question of what change can have the biggest impact on patient safety, the reality is my answer encompasses a lot of changes. This is why I do not envy the decision-making responsibilities of hospital administrators.