Abstract
OBJECTIVE: Routine measurement of patient safety from the patients' perspective receives increasing attention as an important component of safety measurement systems. The aim of this study was to examine patients' experience with patient safety in ambulatory care and the results' implications for routine patient safety measurement in ambulatory care. DESIGN: Cross-sectional mixed-mode survey. SETTING: General practitioner and specialist practices. PARTICIPANTS: Patients aged >18 years seeking care in ambulatory care practices between February and June 2020. METHODS: A 22-item-questionnaire was completed in the practice or at home either on paper or online. Multivariate logistic regression was used to analyse the influence of survey mode and patient characteristics on patient experience with patient safety. RESULTS: The overall response rate was 71.1%. Most patients completed the questionnaire on site (76.6%) and on paper (96.1%). Between 30.1% to 68.5% of the respondents report the most positive option for patient experience with the main domains of patient safety. A total of 2.9% of patients reported having experienced a patient-safety event (PSE) during the last 12 months. Patients who filled in the questionnaire off site were more likely to report negative experiences for the scales communication & information (OR 1.2, 95% CI 1.0-1.5), rapport & participation (OR 1.4, 95% CI 1.1-1.7) and access (OR 1.3, 95% CI 0.9-1.4) than those who completed it on site. Those who chose a paper questionnaire were more likely to report negative experiences for all five scales compared to web responders. CONCLUSION: Routine measurement of patient experience with factors contributing to the occurrence of PSEs can achieve high response rates by offering flexible participation options. Results gained from mixed-mode surveys need to take mode-effects into account when interpreting and using the results. Further research is needed in how to adequately assess number and type of experienced events in routine measurements.