Patient Safety Engagement in Practice: Determinants, Relational Mechanisms, and System-level Influences-A Scoping...

Area of Science:

• Healthcare Management
• Patient Safety Research
• Health Systems Science

Background:

• Patient safety engagement is crucial in healthcare but lacks clear definitions and integration.
• Existing research shows limited understanding of the factors influencing patient engagement in safety processes.

Purpose of the Study:

• To synthesize definitions of patient safety engagement.
• To examine determinants, mediating mechanisms, and system-level influences on engagement behaviors.
• To identify effective strategies for enhancing patient participation in safety.

Main Methods:

• Scoping review of empirical studies linking patient engagement to safety processes.
• Searched major databases (PubMed/MEDLINE, Scopus, Web of Science, CINAHL) from January 2000 to February 2026.
• Included 137 studies analyzing engagement conceptualizations, determinants, and mediators.

Main Results:

• Engagement conceptualized as compliance, behavioral participation, partnership, or shared responsibility.
• Determinants identified at patient, provider, organizational, and system levels.
• Engagement mediated by relational, cognitive, communication, and behavioral acceptability mechanisms, with communication quality and trust being key.
• Patients show a gradient of acceptability, preferring low-confrontation actions.

Conclusions:

• Patient safety engagement is a relational and systems-sensitive practice, not an individual trait.
• Education-only interventions have limited impact; system-oriented strategies are more effective.
• Strengthening relational legitimacy and embedding engagement in workflows are crucial for meaningful participation.