Enhancing Patient Safety in Cardiothoracic Surgery: The Role of Patient Involvement Groups in the UK

This year's theme for the World Health Organization's World Patient Safety Day (17 September) is Engaging Patients For Patient Safety, in recognition of the crucial role patients, families and caregivers play in the safety of health care. Active patient involvement, both in their own personal care as well as at a strategic organisational level, is vital to help improve healthcare provision, and the RCSEd is delighted to support this year's WPSD theme. 

The RCSEd Patient Safety Group have produced a number of blogs as part of a campaign to mark World Patient Safety Day. In this blog, Faisal Jawad covers the enhancing patient safety in cardiothoracic surgery.

Cardiothoracic surgery, a specialized branch requires the utmost precision and care. Patient safety is paramount in this domain. In United Kingdom, we have made significant strides in ensuring the highest standards of care for our patients. A key component of this progress has been the establishment and active involvement of patient groups, which have played a pivotal role in shaping policies, practices, and patient-centred improvements.

The Importance of Patient Safety in Cardiothoracic Surgery

Patient safety is the cornerstone of modern healthcare systems. In cardiothoracic surgery, where even the smallest error can have life-altering consequences, ensuring patient safety is non-negotiable. The UK's healthcare system has made continuous efforts to improve the quality of care delivered to cardiothoracic surgery patients. These efforts include implementing evidence-based practices, standardizing protocols, and embracing technological advancements. However, one of the most powerful tools in the quest for enhanced patient safety has been the integration of patient involvement groups.

The Role of Patient Involvement Groups

Patient involvement groups are platforms where patients, their families, and caregivers collaborate with healthcare providers, administrators, and policymakers to shape healthcare delivery. In the context of cardiothoracic surgery, these groups serve as bridges between medical professionals and patients, allowing patients' voices to be heard and their experiences to be considered in decision-making processes.

1. Improving Communication: Patient involvement groups facilitate open and honest communication between patients and healthcare providers. Through sharing personal experiences and insights, patients contribute to a better understanding of the challenges they face, helping medical teams refine their approaches and communication strategies.
2. Enhancing Safety Protocols: Patients can provide unique perspectives on safety protocols, highlighting potential gaps or areas of improvement that medical professionals might overlook. This collaboration leads to the development of more effective safety measures tailored to patient needs.
3. Influencing Policy and Practice: Patient involvement groups advocate for patient-centred policies and practices. By engaging in discussions about guidelines, procedures, and quality improvement initiatives, these groups contribute to a culture of continuous improvement that prioritizes patient safety.
4. Raising Awareness: Patient stories and experiences shared through these groups can raise awareness about the challenges patients face during cardiothoracic surgery. This increased awareness fosters empathy among healthcare providers and encourages them to prioritize patient safety above all else.

Success Stories and Initiatives

The UK has witnessed several success stories resulting from the collaboration between patient involvement groups and healthcare providers in cardiothoracic surgery:

1. Guideline Development: Patient groups have actively participated in the development of guidelines for preoperative preparation, postoperative care, and long-term management. This ensures that guidelines are practical, patient-friendly, and aligned with patient needs.
2. Risk Mitigation: Patient involvement groups have played a role in identifying potential risks and hazards associated with cardiothoracic surgery procedures. This proactive approach allows healthcare teams to implement preventive measures, reducing the likelihood of adverse events.
3. Quality Improvement Campaigns: Patient groups have initiated campaigns to promote awareness about infection control, medication management, and postoperative care. These campaigns empower patients with information to make informed decisions and actively participate in their own care.

Some specific examples of patient involvement initiatives in cardiothoracic surgery in the UK:

1. The National Cardiac Surgery Patient Liaison Group: This group comprises patients who have undergone cardiac surgery and aims to improve the experiences of future patients. They collaborate with healthcare providers to review patient information materials, ensuring they are clear and comprehensive. Additionally, they provide feedback on the design of patient education materials, helping to enhance patient understanding of procedures and postoperative care.
2. The Heart Valve Voice Patient Council: Heart Valve Voice is a charity that works to improve the lives of people with heart valve disease. Their Patient Council consists of individuals who have experienced heart valve surgery. This council actively participates in conferences, workshops, and policy discussions to share patient perspectives, advocate for improvements in heart valve disease care, and contribute to shaping guidelines that prioritize patient safety.
3. The Papworth Foundation's Patient Involvement Group: The Papworth Foundation, a UK-based healthcare charity, established a Patient Involvement Group focused on cardiothoracic surgery. This group includes patients, carers, and family members who collaborate with clinicians to review patient information materials, provide insights on preoperative and postoperative care, and contribute to the development of patient-centred policies.
4. The Royal Papworth Hospital's "My Heart Surgery" Program: This initiative involves patients who have undergone heart surgery sharing their experiences with others through presentations and informational videos. The program allows patients to explain, in their own words, what the surgery process was like, what challenges they faced, and how they managed their recovery. These personal stories help alleviate fears and uncertainties for other patients, leading to improved psychological well-being and overall patient safety.
5. The Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) Patient and Public Involvement Group: SCTS established a group that includes patients, family members, and caregivers. This group actively participates in shaping the society's initiatives, including reviewing patient information materials, advising on quality improvement projects, and contributing to guidelines development. Their involvement ensures that patient perspectives are integral to shaping the future of cardiothoracic surgery care.
6. Patient Feedback and Safety Reporting Systems: Many UK hospitals have implemented mechanisms for patients to report safety concerns and provide feedback about their experiences. Patient involvement groups have been instrumental in the design and implementation of these systems, ensuring that patient voices are heard and that areas of improvement are addressed promptly to enhance overall patient safety.
7. Aortic Dissection Awareness UK & Ireland is the national patient charity for Aortic Dissection in the UK & Ireland:As a patient-run charity, it aims to provide vital information and support for patients and families affected by the condition; working with highly specialised healthcare providers to improve diagnosis & treatment and reduce healthcare inequalities. They achieve this through partnering with researchers to bring forward new insights that improve future care for Aortic Dissection patients and their families, improving education and awareness through the use of their Booklet “Aortic Dissection: The Patient Guide” and creating a platform for important discussion within parliament.
8. The Thoracic surgery research collaborative patient and public involvement (RESOLVE): is a way by which people with Thoracic surgical conditions, their families, carers or members of the general public can influence research carried out on any topic. The aim of the RESOLVE meeting is to gather valuable feedback on the current and future studies of the thoracic surgery research team of the University Hospitals Birmingham (UHB). An example of the valuable feedback provided by this PPI group is when we presented the Fit4Surgery 2 App; their opinion on the usability of the app for public use was valuable in modifying the app to be more suitable for future patients. By using baseline data collected within the app, the Fit4Surgery app would be able to deliver tailored structured home exercise program, individualized nutritional conditioning, and personalized health information.

These examples showcase the diverse ways in which patient involvement groups in the UK contribute to patient safety in cardiothoracic surgery. Through their active participation, these groups have influenced policies, education, communication strategies, and quality improvement initiatives, ultimately leading to safer and more patient-centred care.

Conclusion

In the UK, patient safety in cardiothoracic surgery has been significantly enhanced through the active involvement of patient groups. These groups have contributed to better communication, enhanced safety protocols, informed policies, and overall improved patient experiences. As the collaboration between patients, healthcare providers, and policymakers continues to grow, the landscape of cardiothoracic surgery is evolving into one that truly prioritizes patient safety above all else.