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Table 1 Intersection of the domains of the framework for safe, reliable and effective care and direct patient and family engagement (Adapted from Frankel et al., [9])

From: Structured approaches to promote patient and family engagement in treatment in acute care hospital settings: protocol for a systematic scoping review

IHI domain

Patient and family engagement strategies

Leadership and accountability

Patients and the healthcare need to agree on goals and clearly define roles and accountability for goal achievement

Clinical team members offer advice on clinical components

Patients and families give their perspectives until there is agreement on goals

Teamwork and communication

Patients and families are considered part of the team and receive accurate, timely, and relevant communication about their health and care

Psychological safety

Patients should feel psychologically safe to share their concerns with the clinical team

Healthcare team members receive patient perspectives openly and without judgment

Patients are encouraged to be transparent about clinical signs, symptoms and treatment adherence


The healthcare team engages in collaborative negotiation with patients and families

Healthcare team knows the patients’ priorities, worries, and desired outcomes


Transparency with patients and families, particularly with respect to adverse events, is promoted

Opportunities for patients and families to engage in care, making use of opportunities such as patient portals


Patients can help to develop ways to make the process more reliable

Improvement and measurement

Patients share perspectives, experiences, and ideas about ongoing improvement efforts