OpenNotes evidence has shown that transparent medical records can increase patient engagement - patients who read the clinical notes written by their doctors report feeling more in control of their care and being better able to adhere to the treatment plan. Now new research from OpenNotes investigators at Beth Israel Deaconess Medical Center (BIDMC) suggests that offering patients a mechanism to provide feedback about their notes further enhances engagement and can improve patient safety. The study results appear online today in the British Medical Journal (BMJ) Quality and Safety.
Lead author Sigall Bell, MD, is the OpenNOtes director of patient safety and discovery and associate professor of medicine at Harvard Medical School. Courtesy of Jay Dobek
OpenNotes evidence has shown that transparent medical records can increase patient engagement - patients who read the clinical notes written by their doctors report feeling more in control of their care and being better able to adhere to the treatment plan. Now new research from OpenNotes investigators at Beth Israel Deaconess Medical Center (BIDMC) suggests that offering patients a mechanism to provide feedback about their notes further enhances engagement and can improve patient safety. The study results appear online today in the British Medical Journal (BMJ) Quality and Safety.
"Our findings add to a growing literature suggesting that patients can help identify mistakes," says lead author, Sigall Bell, MD, OpenNotes director of patient safety and discovery and associate professor of medicine at Harvard Medical School. "We were struck that nearly all patients and care partners in the study found the feedback tool valuable. What that indicates to us is that patients are eager to help their health care teams 'get it right.'"
What's more, Bell says, the majority of patients who reported a possible inaccuracy also provided positive feedback, with one doctor commenting that it was an 'anti-burnout' experience.
Bell and colleagues created a simple, low cost, online feedback tool that patients could link to from their notes on the secure, patient portal. 41 doctors signed on to the pilot intervention, and 6225 patient visits were included in the one year study period. During that time 44 percent of patients read their notes, and among them one in 12 used the reporting tool.
Bell found that nearly all (96 percent) of the patients who sent feedback reported understanding the content of the note. Among those who provided feedback, 23 percent reported potential safety concerns, most commonly citing possible mistakes regarding medications, or documentation of existing health problems or symptoms. Upon clinician review, 64 percent of the patient reported items were confirmed as definite or possible safety concerns, and 57 percent of the cases resulted in a change to the record or care.
Bell says that what didn't happen during the study period is equally as important. Although some clinicians worried that identification of errors in notes may adversely affect the patient-doctor relationship, not a single doctor in the small pilot reported such an event. After a year, 99 percent of patients and care partners found the tool valuable, 97 percent wanted it to continue, and none of the doctors reported worsening workflow.
"We were pleased to find that the OpenNotes reporting tool helped to identify quality improvement opportunities without appearing to add to clinician burden," says Bell. "We believe that if patients know their feedback is welcome and encouraged, the potential to reduce errors or clear up confusion about the care plan will be even greater."
The reporting tool is currently being piloted at Boston Children's Hospital under the guidance of Fabienne Bourgeois, MD, MPH , pediatric hospitalist and the Medical Director of Patient-Facing Applications.
In addition to Bell, study authors include Macda Gerard; Alan Fossa MPH; Tom Delbanco, MD; Barbara Sarnoff Lee, LICSW; Kenneth Sands, MD; Patricia Folcarelli, PhD; and Jan Walker, RN, MBA all of Beth Israel Deaconess Medical Center.
Bell's research is supported by CRICO/Risk Management Foundation of the Harvard Medical Institutions.
Source: Beth Israel Deaconess Medical Center
Dear Helpdesk: Working in a Toxic Health Care Environment
March 28th 2024Dear Helpdesk is your steadfast companion, offering life coaching and workplace advice from 2 seasoned IPs for some of your most challenging real-life situations. Let us help you navigate the intersection between work and life, guiding you to navigate the dynamic world of infection prevention with confidence and grace. This article is on handling a toxic health care environment.
Product Locator: Spring and Early Mother's Day Gift Guide for Infection Prevention Personnel
March 27th 2024Whether it's a spring holiday, birthdays, or no reason at all, infection prevention personnel love to give and receive gifts that help at the end of a stressful day. Infection Control Today® offers some gift ideas for infection prevention personnel and their families.
Catching Up With Vangie Dennis, AORN 2022-2023 President at AORN 2024
March 26th 2024Infection Control Today (ICT) had the privilege of catching up with Vangie Dennis, MSN, RN, CNOR, CMLSO, at the Association of periOperative Registered Nurses' (AORN’s) International Surgical Conference & Expo 2024. As the former president of AORN and an esteemed figure in perioperative services, Vangie Dennis shared insights into her recent endeavors and the exciting new chapter she's embarked upon.
How To Optimize Your Time Management Strategies for the Busy Infection Preventionist
March 25th 2024Is your calendar resembling a chaotic masterpiece of overlapping tasks? Join the club of infection preventionists striving to balance responsibilities. Dive into proven strategies from a fellow infection preventionist to reclaim control of your time, streamline tasks, and boost productivity effectively. This is an IP Lifeline article.