Educating seniors to be patient safety self-Advocates in primary care

OBJECTIVES:: Most advice to patients regarding advocating for their safety relates to hospital care and is not grounded in the patient experience. We developed a patient-centered intervention to train elderly patients to be self-advocates for safer care in ambulatory settings. METHODS:: We pilot-tested a 2-part intervention that 1) educated the elderly regarding their role in identifying and preventing common errors in primary care and 2) provided them with skills to improve communication with health care providers. Participants completed a validated 21-question Seniors Empowerment and Advocacy in Patient Safety (SEAPS) survey before and 2 to 3 months after participation. Paired sample t tests were used to measure the impact of the intervention at 2 periods. In addition, field notes of participant comments regarding the intervention were analyzed qualitatively using immersion and crystallization. RESULTS:: The mean total SEAPS score of the 61 participants (mean age, 74.5 years) improved from 44.6 to 48.3 (range, 0-63; P < 0.001). All demographic groups (sex, race, education, and frequency of doctors' visits) showed significant improvement except those with more than a high school education. All participants acknowledged learning new skills and ideas, as well as new ways of organizing their own health care information. Participants noted needed improvements in the intervention related to the roles that others are asked to play. CONCLUSIONS:: Although intensive in effort, this pilot intervention demonstrated that elderly patients can improve their beliefs and self-reported safety behaviors in the ambulatory setting. Further work is needed to confirm the most useful aspects of the training and assess its impact on error reduction.