门诊不良事件 (AE) 影响着全球多达 25% 的人口，并导致全球超过 700 万人因本可预防而入院。尽管患者和护理人员是促进和监控自身门诊安全的关键参与者，但医疗团队传统上并不与患者合作开展安全工作。我们试图确定患者和护理人员在参与动态 AE 审查时的贡献，重点关注资源贫乏的护理环境。我们从隶属于一个机构的初级保健诊所招募了会说英语、西班牙语和/或粤语的成年患者、护理人员和患者顾问。美国公共卫生网络。所有人都有服用或管理高风险药物（血液稀释剂、胰岛素或阿片类药物）的经验。我们提出了两种典型的动态 AE：一种涉及华法林药物间相互作用，另一种涉及结肠癌的延迟诊断。我们进行了半结构化焦点小组和访谈，以了解参与者对类似不良事件的因果因素和潜在预防措施的看法。研究团队进行了混合归纳演绎定性分析，以推导出主要主题。样本包括 6 名讲英语的患者（2 名焦点小组，4 名个人访谈）、6 名讲西班牙语的患者（个人访谈）、4 名讲粤语的患者患者（2 名焦点小组，2 次访谈）和 6 名讲英语的患者顾问（焦点小组）。主题包括：（1）患者和团队具有特定的安全责任； (2) 主动沟通推动安全的门诊护理； (3) 与有限资源相关的障碍会导致流动性不良事件。患安全网卫生系统中的患者和护理人员可以切实参与 AE 审查，以确保安全举措包含他们的宝贵观点。© 作者（或其雇主）2024。禁止商业重复使用。请参阅权利和权限。由英国医学杂志出版。

Ambulatory adverse events (AEs) affect up to 25% of the global population and cause over 7 million preventable hospital admissions around the world. Though patients and caregivers are key actors in promoting and monitoring their own ambulatory safety, healthcare teams do not traditionally partner with patients in safety efforts. We sought to identify what patients and caregivers contribute when engaged in ambulatory AE review, focusing on under-resourced care settings.We recruited adult patients, caregivers and patient advisors who spoke English, Spanish and/or Cantonese, from primary care clinics affiliated with a public health network in the USA. All had experience taking or managing a high-risk medication (blood thinners, insulin or opioid). We presented two exemplar ambulatory AEs: one involving a warfarin drug-drug interaction, and one involving delayed diagnosis of colon cancer. We conducted semistructured focus groups and interviews to elicit participants' perceptions of causal factors and potential preventative measures for similar AEs. The study team conducted a mixed inductive-deductive qualitative analysis to derive major themes.The sample included 6 English-speaking patients (2 in the focus group, 4 individual interviews), 6 Spanish-speaking patients (individual interviews), 4 Cantonese-speaking patients (2 in the focus group, 2 interviews), and 6 English-speaking patient advisors (focus group). Themes included: (1) Patients and teams have specific safety responsibilities; (2) Proactive communication drives safe ambulatory care; (3) Barriers related to limited resources contribute to ambulatory AEs. Patients and caregivers offered ideas for operational changes that could drive new safety projects.An ethnically and linguistically diverse group of primary care patients and caregivers defined their agency in ensuring ambulatory safety and offered pragmatic ideas to prevent AEs they did not directly experience. Patients and caregivers in a safety net health system can feasibly participate in AE review to ensure that safety initiatives include their valuable perspectives.© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.