Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety

Bronwyn Newman*, Kathryn Joseph, Ashfaq Chauhan, Holly Seale, Jiadai Li, Elizabeth Manias, Merrilyn Walton, Stephen Mears, Benjamin Jones, Reema Harrison

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)
11 Downloads (Pure)


Background: Patients are increasingly being asked for feedback about their healthcare and treatment, including safety, despite little evidence to support this trend. This review identifies the strategies used to engage patients in safety during direct care, explores who is engaged and determines the mechanisms that impact effectiveness.

Methods: A systematic review was performed of seven databases (CINAHL, Cochrane, Cochrane-Central, Embase, ISI Web of Science, Medline, PsycINFO) that included research published between 2010 and 2020 focused on patient engagement interventions to increase safety during direct care and reported using PRISMA. All research designs were eligible; two reviewers applied criteria independently to determine eligibility and quality. A narrative review and realist synthesis were conducted.

Results: Twenty-six papers reporting on twenty-seven patient engagement strategies were included and classified as consultation (9), involvement (7) and partnership (11). The definitions of 'patient engagement' varied, and we found limited details about participant characteristics or interactions between people utilizing strategies. Collaborative strategy development, a user-friendly design, proactive messaging and agency sponsorship were identified as mechanisms to improve engagement about safety at the point of direct care.

Conclusions: Agency sponsorship of collaboration between staff and patients is essential in the development and implementation of strategies to keep patients safe during direct care. Insufficient details about participant characteristics and patient-provider interactions limit recommendations for practice change. More needs to be learned about how patients are engaged in discussions about safety, particularly minority groups unable to engage with standard information.

Patient or Public Contribution: Review progress was reported to the CanEngage team, including the consumer steering group, to inform project priorities (PROSPERO CRD42020196453).

Original languageEnglish
Pages (from-to)1905-1923
Number of pages19
JournalHealth Expectations
Issue number6
Early online date25 Aug 2021
Publication statusPublished - Dec 2021

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • patient engagement
  • patient participation
  • patient safety
  • point of care
  • systematic review


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