BACKGROUND: Despite continued efforts to improve safety in hospitals, hospital-acquired harm persists. Strategies have been identified to establish patient-centered care and improve patient engagement with care. However, the relationship of patient and family engagement to reduction of harm is not well understood, with limited findings available in current literature.

PURPOSE: This qualitative study explored the perceptions and attitudes of patients and family members and several clinical disciplines toward patient engagement in reducing preventable harm in hospitalized patients.

METHODS: We conducted 8 focus groups at 2 nonprofit hospitals with several constituencies: patients/families, registered nurses, physician hospitalists, and pharmacists/physical therapists.

RESULTS: Thematic analysis of transcripts revealed multiple themes from different perspectives, including: family presence increases safety, the hospital environment is intimidating, and communication is essential, but I am not being heard.

CONCLUSIONS: The rich data suggest a significant opportunity for reducing risk and harm by more actively engaging patients and families in the effort. Increasing patient acuity and complexity of care furthers the need for partnering with patients and families more intentionally for increased safety.