Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families

Research shows that when patients are engaged in their health care, it can lead to measurable improvements in safety and quality. To promote stronger engagement, the Agency for Healthcare Research and Quality (AHRQ) is developing a guide to help patients, families, and health professionals in primary care settings work together as partners to promote improvements in care.

This ongoing project focuses on developing approaches to improve patient safety in primary care settings through the engagement of patients and families.

About This Project

Patient and family engagement (PFE) is an evolving concept in health care transformation and has been described as the "blockbuster drug" of the 21st Century."1 A growing body of evidence suggests that PFE can improve the safety and quality of care delivery.2–6 Building sustainable processes and practice- based infrastructure is crucial to improving patient safety by PFE in primary care.

This 38-month project started in September 2015 and will develop four interventions aimed at engaging patients and families as partners in primary care with the goal of improving patient safety. The project is similar to AHRQ's Guide to Patient and Family Engagement in Hospital Quality and Safety, which was developed for the hospital setting. The interventions will be released individually and as part of a comprehensive guide for medium and large primary care practices to adopt as part of their practice improvement efforts. The guide will be field tested in 12 primary care practices and revised based on patient, provider, and primary care practice staff feedback.

This project will generate a number of resources to help primary care practices, primary care providers, and patients increase PFE in care. These resources include:

  • Environmental scan report describing approaches to engage patients and families in primary care settings and how engagement leads to improved safety.
  • Case studies on exemplar practices that have increased PFE in primary care and affected patient safety.
  • Four interventions and accompanying instructional materials for primary care practices to adopt aimed at engaging patients and families to improve patient safety.
  • Comprehensive guide of interventions, instructional materials, and guidance for adoption and measurement of success.

These resources will be made available to primary care practices, providers, and patients as they are developed over the 38-month project.

Project Team

This project is led by the MedStar Health Research Institute. To contact the project team, email Kelly Smith, Ph.D., project co- principal investigator at

Development Partners

The partners for this work include Project Patient Care, Consumers Advancing Patient Safety, MedStar Institute for Quality and Safety, MedStar Institute for Innovation, Prince George's County Department of Health, Capital Area Primary Care Research Network (CAPRICORN), Clinical Directors Network, CVS Health, Iowa Healthcare Collaborative, and Telligen Quality Innovation Network-Quality Improvement Organization.

Dissemination Partners

To Be Determined.

For more information about the environmental scan or the Guide to Improving Safety in Primary Care Settings by Engaging Patients and Families, contact Margie Shofer at (301) 427-1696 or


  1. Dentzer S. Rx for the "blockbuster drug" of patient engagement. Health Aff (Millwood) 2013;32(2):202.
  2. Herrin J, Harris KG, Kenward K, et al. Patient and family engagement: a survey of US hospital practices. BMJ Qual Saf 2016 Mar;25(3):182-9. Epub 2015 Jun 16. doi:10.1136/bmjqs-2015-004006.
  3. Smith KM, Hatlie MJ, Mayer DB, et al. A 10-year journey engaging patients in patient safety education, research, and improvement. The Golden Bridge: Communication and Patient Safety. International Society for Communication Science and Medicine Conference. Montecatini Terme, Italy; 15-16 June 2015:SP57, p. 36. 4dfe4b089431662d174/1444758751213/LibrettoProgramma.pdf.
  4. Agency for Healthcare Research and Quality. Guide to Patient and Family Engagement in Hospital Quality and Safety. Accessed March 7, 2016.
  5. Scholle S, Torda P, Peikes D, et al. Engaging patients and families in the medical home. (Prepared by Mathematica Policy Research under Contract No. HHSA290200900019I TO2.) Rockville, MD: Agency for Healthcare Research and Quality; June 2010.  AHRQ Publication No. 10-0083-EF. (526 KB). Accessed March 7, 2016.
  6. Lewis B. PFACs: Where's the money? The financial impact on hospitals. Patient Experience Research Report. Bedford, TX: Beryl Institute; 2014. (310 KB). Accessed March 7, 2016.
Page last reviewed April 2017
Page originally created March 2016
Internet Citation: Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families. Content last reviewed April 2017. Agency for Healthcare Research and Quality, Rockville, MD.