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])

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
Negotiation	The healthcare team engages in collaborative negotiation with patients and families
	Healthcare team knows the patients’ priorities, worries, and desired outcomes
Transparency	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
Reliability	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