The HAS is taking part in World Patient Safety Day on 17 September 2023

World Patient Safety Day, initiated by the World Health Organization (WHO), is being held on 17 September, as it is every year. The theme of the 2023 event - “Engaging patients for patient safety” - highlights the crucial role patients, supported persons and families play in the safety of healthcare, alongside caregivers. As a long-standing promoter of this policy, the HAS works to foster, facilitate and improve healthcare user participation and engagement, whether in its action plans, programmes and tools, or within facilities and their governing bodies. It endorses the call to “Elevate the voice of patients!”, as well as that of supported persons, focusing on a selection of its recent work contributing to this objective. 

As the WHO highlights, “evidence shows that when [users] are treated as partners in their care, significant gains are made in safety, patient satisfaction and health outcomes. By becoming active members of the healthcare team, patients can contribute to the safety of their care and that of the healthcare system as a whole.”

It is precisely on the basis of this evidence that the HAS has long pursued an active policy of engaging users in healthcare safety. Its work covers a broad range of areas, from preventive initiatives through to safety improvement action plans, including the incorporation of the patient's story in the analysis of adverse events, as well as the recording of patient satisfaction and the perspectives of supported persons, in the health, medico-social and social fields. This article presents a selection of recent HAS publications.

Informing users prior to healthcare or treatments in order to prevent health risks

Some pain medications, such as opioids, can expose patients to risks of misuse, dependence or overdose. To foster the engagement of the people concerned in the management of these risks, the HAS encourages them to talk to their physician and provides access to two information sheets; one is aimed at people with chronic pain and the other at the users of such medications. The HAS has also published guidelines aimed at professionals: Good practice guidelines for opioid medicines: analgesia, prevention and management of misuse and overdoses.

Fostering a relationship of trust between patients and caregivers to improve the safety of use of medicines during care or treatment

In the event of hospitalisation, some care teams offer patients the opportunity to take their medicines independently during their stay in their department. To help users decide whether or not to give their informed consent to this “self-administration of medicinal products” and to ensure that it takes place within a safe framework, the HAS has published a document explaining the process, entitled “Taking your medication on your own”.

The HAS proposes a framework for professionals to ensure the safety of the practice of “patient self-administration of medicines during hospitalisation” via a guide and a toolkit. Use of the guide by professionals is currently being tested.

Including the patient’s story in the analysis of the event if a care-related adverse event occurs

If it has not been possible to avoid a care-related adverse event (CRAE), including the patient's story in the analysis of the event can help professionals understand the causes and consequences so that they can learn lessons for the future and thereby prevent the event from happening again.

In concrete terms, the patient concerned may be asked by the care team (they are free to accept or refuse) to share their experience in order to better determine and understand what has happened.

In a patient information sheet entitled “Care-related adverse event: the care team would like to hear your story”, the HAS explains how the patient's experience is crucial.

There are also documents aimed at professionals: Analysis of care-related adverse events (CRAEs): instructions for use.

Recording user satisfaction through the evaluation of care and support services, after their care or treatments

• Measurement of patient experience and satisfaction

Measuring patient experience is vital to improving the safety of healthcare. Since 2016, the HAS has run the e-Satis survey, a continuous national survey to measure hospitalised patient satisfaction and experiences. Concretely, two weeks following their discharge from hospital, patients automatically receive an e-mail containing a secure link enabling them to complete the e-Satis questionnaire online. Hospitals can use the anonymised responses received from their patients on an ongoing basis. Once a year, the HAS produces satisfaction and experience scores for hospitalised patients, both nationally and by hospital facility. The results are published on QualiScope, the HAS information service on the level of quality and safety of care in all healthcare facilities in France.

Since 2016, millions of patient experiences in healthcare facilities have been collected and analysed, making e-Satis a unique initiative with no equivalent internationally.

See also posters aimed at patients and the educational video.

• Measuring patient-reported quality of care

The HAS promotes the use of PROMs (questionnaires used to measure patient-reported outcomes) in everyday clinical practice, providing guides aimed at healthcare professionals.

For more information on measuring patient-reported quality of care and HAS actions in this area, consult the dedicated page.

To find out more about user participation and engagement on different levels

• in multiprofessional programmes aimed at improving the safety of patient care

In its collaborative continuous teamwork improvement programme (Pacte), the HAS has always included patients in its definition of the team. It recently created a specific module entitled “patient engagement in the Pacte team” providing professionals with the keys required to successfully include more patients. This module is composed of a guide and a toolkit.

• in social and medico-social facilities and services

Gathering the views of supported persons is essential in order to improve the support provided by social and medico-social facilities and services. To do this, it is necessary to have methodological, ethical and organisational support. The HAS proposes to offer its expertise to support social and medico-social facilities and services in their initiatives by rolling out a multi-year programme. The main objective is to enable people to be active partners in their support pathway.

For more information, read the scoping document

A first guide on “Collecting the viewpoints of people living in or using a residential care home for dependent elderly people (EHPAD)” will be published shortly.

Recording the experience of supported persons is also a key pillar of the new system for evaluating social and medico-social facilities and services, which has been in place since 1 January 2023. Now, any assessment visit to a facility must include an interview with at least three people accommodated within or using the service or facility, as well as with the members of the care home’s social council.

• in the bodies of healthcare social and medico-social facilities
  
  Improving the representation and participation of users and supported persons in health, social and medico-social facilities is crucially important in terms of the safety of care and support. Through its User Involvement Council (CEU), the HAS proposes ways forward and has published three documents:
  • aimed at social and medico-social facilities and services: Facilitating and improving the representation of supported persons on social councils (CVS);
  • aimed at healthcare facilities, hospitals and clinics: Facilitating and improving the representation of users on user committees (CDU);
  • aimed at facility managers and teams: Facilitating self-assessment of the operation of the body in which users participate.

For more information, read the dedicated page and the full opinion issued by the HAS “Improving user involvement in user committees and social councils”.

• within national institutions, such as the HAS

Why get involved as a user expert at the HAS? Watch a video of user and supported person testimonies.

In conclusion, to help constantly improve the quality of care and support, the HAS has published a guideline, entitled “Supporting and encouraging user engagement in the social, medico-social or health sectors” underpinning its strategic priority to “Make public engagement a priority”. With regard to improving the quality and safety of care and support, the following recommendations are made, in particular:

1. to integrate the experiences of the people concerned, both in the evaluation of social support practices and in the quality and safety of care;

2. to systematically propose to users' representatives and elected members of social councils (CVS) that they collaborate in processes to evaluate practices and organisations, or even jointly construct these processes with them, while respecting professional confidentiality (for example, in the context of internal and external evaluations of social and medico-social facilities and services or the certification of healthcare facilities), etc.

For more information, consult the dedicated page on the HAS website.

An easy to read and understand version of the guideline will shortly be available.

• For more information about World Patient Safety Day on 17 September 2023, consult the dedicated page on the World Health Organization
• To follow the event on social media: #PatientSafety; #WorldPatientSafetyDay