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How to have healthcare safety conversations

Most of us expect care to be safe. However, a small proportion of people experience some type of unintended harm as a result of the care they receive. Healthcare providers want to work with you to help keep you safe. 

What are safety conversations?
Patients and families are a valuable source of information and an expert in your own care. You can help create safety and prevent harm by identifying risks, hazards and safety incidents that could remain otherwise undetected.

If you see, hear or feel something is not right, it’s important that you speak up. Safety conversations are one way we can all work together to improve patient safety. They involve respectful discussions about safety between you and those who provide care to you or your loved one.

Why have safety conversations?
Safety conversations help you and your loved ones stay safe. They allow you to gain more information than you already have about any aspect of the care being discussed or provided to you. Those who ask questions and take an active role in their care see greater improvement in their health than those who don’t.

How to prepare for safety conversations
Here are some steps you can follow to help you prepare for safety conversations with your healthcare providers and care partners:

Step 1: Feeling safe to talk about safety
Not everyone will feel comfortable to talk about safety. If you or a loved one has experienced harm as a result of healthcare you received in the past, you may be hesitant or uncomfortable to share how you feel openly and honestly due to fear of being further judged, discriminated against, not listened to, or reprimanded.   

Before safety conversations can take place, and when you feel ready to talk about safety, those providing care should arrange a time and place to meet that you and your loved one are comfortable with. You can also ask to have an essential care partner join you for safety conversations.

Step 2: Ask
Asking questions is an important way to begin safety conversations. Those providing care to you should begin by asking you or your loved one questions. By doing this, they take the pressure off you to speak up first. Some questions you may be asked include:
• What makes you feel safe?
• What would make you feel safer?
• What makes you feel unsafe?
• What are your care preferences (for example, ‘what matters to you?’)?
• Tell me about anything that alarmed or worried you in the past 24 hours?
• Tell me about harm you have you experienced or witnessed in the past 24 hours?
• What has made you feel unsafe in the past 24 hours (or since we last talked)?

Thinking about these questions before you have safety conversations will help you feel prepared to discuss actions to make your care safer. It also helps if you stay informed, discuss information, concerns and suggestions, and work closely with your care providers across the care journey. If you’re not sure about how to communicate your concerns to the healthcare team, you could say:
• I’m concerned about my or my loved one’s condition
• I’m uncomfortable with my or my loved one’s condition
• I believe my safety or the safety of my loved one is at risk

Step 3: Listen
An important part of safety conversations involves listening to what is said. During safety conversations, you can ask those providing care to learn from you or your loved one and acknowledge your role as experts in your care. You are an extra set of eyes and ears that should be integrated into care. You know your symptoms and your responses to treatments better than anyone else. You are highly invested in your own well-being and outcomes. You are always present in your own care and you are the first to know or feel when a symptom changes or you experience treatment impacts. You are an important member of the team.

Step 4: Act
After safety conversations happen, ask healthcare providers to:
• Work with you to identify and implement solutions for safety concerns you have discussed
• Provide you with information so you can anticipate what is coming, assess risks and benefits and make informed healthcare decisions
• Outline specific steps that will be taken so you know what to expect and when
• Loop back to you to share how your concerns were addressed
• Communicate and agree on care plans in advance so you have time to plan and prepare.   

For more information on safety conversations and patient safety, visit 

To contact a member of Healthcare Excellence Canada’s safety team, please email

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