Tools, interventions, and quality improvement initiatives for improving patient safety in the primary care setting through patient and family engagement: an umbrella scoping review

Patient and family engagement (the process of building the capacity of patients, families, carers, as well as health care providers, to facilitate and support the active involvement of patients in their own care, in order to enhance safety, quality and people-centrednessof health care service delivery) is a high priority for improvement in patient safety in primary care.

We aimed to identify and synthesize the scope of available research about tools, interventions and quality improvement initiatives for improving patient safety in primary care through patient and family engagement.

This scoping review´s protocol followed Joanna Briggs Institute and PRISMA guidelines. We used specifically tailored electronic search algorithms with a combination of controlled vocabulary and search terms in MEDLINE, EMBASE, and the Cochrane Library. Eligible studies were evidence syntheses in English that reported the development, implementation or impact of relevant interventions, tools, or quality improvement initiatives. References were screened with Ryyan tool. We extracted study data regarding publication, aims, study population, methodology, scope, and level of engagement.

Out of initial 1,115 references, 27 syntheses were included. Most of them (74%) consisted of systematic literature reviews, and 70% were published from 2015 onwards. Eight reviews specifically focused on primary care whereas the rest were not setting-specific. Most frequently researched topics included medications (particularly their management across transitions of care and their side effects), and detection errors.
Only a minority of reviews focused on specific approaches for involving patients, such as individual information-sharing sessions for proactive symptom monitoring and understanding of medications or facilitating patients to ask questions.
We identified rich information regarding future research needs, including:evidence gaps methodological approaches; conceptualization and measurement of patient involvement and of patient safety; intervention design, and intervention target population

A body of research supports best evidence for improving patient safety in primary care through patient and family engagement.