… and significantly impaired safety culture.   … Hicks S, Stavropoulou C. The effect of health care professional …

The theme of "unmet expectations" runs through this article, which uses narrative inquiry to identify the safety concerns of patients undergoing elective surgery. Similar to the classic article "A Hospitalization From Hell," unsympathetic attitudes and poor communication frequently marred patients' hospitalizations, leaving them dissatisfied despite good technical results.

Interventions to engage patients in safety efforts have thus far yielded mixed results. This systematic review found 68 articles that either described interventions to engage patients in safety or examined patients' perspectives on being actively involved in their safety. The authors identified four potential barriers to patients' involvement in safety: illness severity, cognitive characteristics (including language barriers), poor physician–patient communication, and organizational factors (including safety culture). Another recent review established a framework for how organizations can stimulate patient engagement in safety efforts.