A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships. Bell, S. K, Gerard, M., Fossa, A., Delbanco, T., Folcarelli, P. H, Sands, K. E, Sarnoff Lee, B., & Walker, J. BMJ Quality & Safety, 26(4):312–322, April, 2017. ![A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background OpenNotes, a national movement inviting patients to read their clinicians’ notes online, may enhance safety through patientreported documentation errors. Objective To test an OpenNotes patient reporting tool focused on safety concerns. Methods We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015. A link at the end of the note led to a 9-question survey. Patient Relations personnel vetted responses, shared safety concerns with providers and documented whether changes were made. Results 2736/6225(44%) of patients read notes; among these, 1 in 12 patients used the tool, submitting 260 reports. Nearly all (96%) respondents reported understanding the note. Patients and care partners documented potential safety concerns in 23% of reports; 2% did not understand the care plan and 21% reported possible mistakes, including medications, existing health problems, something important missing from the note or current symptoms. Among these, 64% were definite or possible safety concerns on clinician review, and 57% of cases confirmed with patients resulted in a change to the record or care. The feedback tool exceeded the reporting rate of our ambulatory online clinician adverse event reporting system severalfold. After a year, 99% of patients and care partners found the tool valuable, 97% wanted it to continue, 98% reported unchanged or improved relationships with their clinician, and none of the providers in the small pilot reported worsening workflow or relationships with patients. Conclusions Patients and care partners reported potential safety concerns in about one-quarter of reports, often resulting in a change to the record
@article{bell_patient_2017,
title = {A patient feedback reporting tool for {OpenNotes}: implications for patient-clinician safety and quality partnerships},
volume = {26},
issn = {2044-5415, 2044-5423},
shorttitle = {A patient feedback reporting tool for {OpenNotes}},
url = {https://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2016-006020},
doi = {10.1136/bmjqs-2016-006020},
abstract = {Background OpenNotes, a national movement inviting patients to read their clinicians’ notes online, may enhance safety through patientreported documentation errors.
Objective To test an OpenNotes patient reporting tool focused on safety concerns.
Methods We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015. A link at the end of the note led to a 9-question survey. Patient Relations personnel vetted responses, shared safety concerns with providers and documented whether changes were made.
Results 2736/6225(44\%) of patients read notes; among these, 1 in 12 patients used the tool, submitting 260 reports. Nearly all (96\%) respondents reported understanding the note. Patients and care partners documented potential safety concerns in 23\% of reports; 2\% did not understand the care plan and 21\% reported possible mistakes, including medications, existing health problems, something important missing from the note or current symptoms. Among these, 64\% were definite or possible safety concerns on clinician review, and 57\% of cases confirmed with patients resulted in a change to the record or care. The feedback tool exceeded the reporting rate of our ambulatory online clinician adverse event reporting system severalfold. After a year, 99\% of patients and care partners found the tool valuable, 97\% wanted it to continue, 98\% reported unchanged or improved relationships with their clinician, and none of the providers in the small pilot reported worsening workflow or relationships with patients.
Conclusions Patients and care partners reported potential safety concerns in about one-quarter of reports, often resulting in a change to the record},
language = {en},
number = {4},
urldate = {2026-07-15},
journal = {BMJ Quality \& Safety},
author = {Bell, Sigall K and Gerard, Macda and Fossa, Alan and Delbanco, Tom and Folcarelli, Patricia H and Sands, Kenneth E and Sarnoff Lee, Barbara and Walker, Jan},
month = apr,
year = {2017},
pages = {312--322},
}
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{"_id":"Fpxa6qL8eXuXgA655","bibbaseid":"bell-gerard-fossa-delbanco-folcarelli-sands-sarnofflee-walker-apatientfeedbackreportingtoolforopennotesimplicationsforpatientcliniciansafetyandqualitypartnerships-2017","author_short":["Bell, S. K","Gerard, M.","Fossa, A.","Delbanco, T.","Folcarelli, P. H","Sands, K. E","Sarnoff Lee, B.","Walker, J."],"bibdata":{"bibtype":"article","type":"article","title":"A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships","volume":"26","issn":"2044-5415, 2044-5423","shorttitle":"A patient feedback reporting tool for OpenNotes","url":"https://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2016-006020","doi":"10.1136/bmjqs-2016-006020","abstract":"Background OpenNotes, a national movement inviting patients to read their clinicians’ notes online, may enhance safety through patientreported documentation errors. Objective To test an OpenNotes patient reporting tool focused on safety concerns. Methods We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015. A link at the end of the note led to a 9-question survey. Patient Relations personnel vetted responses, shared safety concerns with providers and documented whether changes were made. Results 2736/6225(44%) of patients read notes; among these, 1 in 12 patients used the tool, submitting 260 reports. Nearly all (96%) respondents reported understanding the note. Patients and care partners documented potential safety concerns in 23% of reports; 2% did not understand the care plan and 21% reported possible mistakes, including medications, existing health problems, something important missing from the note or current symptoms. Among these, 64% were definite or possible safety concerns on clinician review, and 57% of cases confirmed with patients resulted in a change to the record or care. The feedback tool exceeded the reporting rate of our ambulatory online clinician adverse event reporting system severalfold. After a year, 99% of patients and care partners found the tool valuable, 97% wanted it to continue, 98% reported unchanged or improved relationships with their clinician, and none of the providers in the small pilot reported worsening workflow or relationships with patients. Conclusions Patients and care partners reported potential safety concerns in about one-quarter of reports, often resulting in a change to the record","language":"en","number":"4","urldate":"2026-07-15","journal":"BMJ Quality & Safety","author":[{"propositions":[],"lastnames":["Bell"],"firstnames":["Sigall","K"],"suffixes":[]},{"propositions":[],"lastnames":["Gerard"],"firstnames":["Macda"],"suffixes":[]},{"propositions":[],"lastnames":["Fossa"],"firstnames":["Alan"],"suffixes":[]},{"propositions":[],"lastnames":["Delbanco"],"firstnames":["Tom"],"suffixes":[]},{"propositions":[],"lastnames":["Folcarelli"],"firstnames":["Patricia","H"],"suffixes":[]},{"propositions":[],"lastnames":["Sands"],"firstnames":["Kenneth","E"],"suffixes":[]},{"propositions":[],"lastnames":["Sarnoff","Lee"],"firstnames":["Barbara"],"suffixes":[]},{"propositions":[],"lastnames":["Walker"],"firstnames":["Jan"],"suffixes":[]}],"month":"April","year":"2017","pages":"312–322","bibtex":"@article{bell_patient_2017,\n\ttitle = {A patient feedback reporting tool for {OpenNotes}: implications for patient-clinician safety and quality partnerships},\n\tvolume = {26},\n\tissn = {2044-5415, 2044-5423},\n\tshorttitle = {A patient feedback reporting tool for {OpenNotes}},\n\turl = {https://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2016-006020},\n\tdoi = {10.1136/bmjqs-2016-006020},\n\tabstract = {Background OpenNotes, a national movement inviting patients to read their clinicians’ notes online, may enhance safety through patientreported documentation errors.\nObjective To test an OpenNotes patient reporting tool focused on safety concerns.\nMethods We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015. A link at the end of the note led to a 9-question survey. Patient Relations personnel vetted responses, shared safety concerns with providers and documented whether changes were made.\nResults 2736/6225(44\\%) of patients read notes; among these, 1 in 12 patients used the tool, submitting 260 reports. Nearly all (96\\%) respondents reported understanding the note. Patients and care partners documented potential safety concerns in 23\\% of reports; 2\\% did not understand the care plan and 21\\% reported possible mistakes, including medications, existing health problems, something important missing from the note or current symptoms. Among these, 64\\% were definite or possible safety concerns on clinician review, and 57\\% of cases confirmed with patients resulted in a change to the record or care. The feedback tool exceeded the reporting rate of our ambulatory online clinician adverse event reporting system severalfold. After a year, 99\\% of patients and care partners found the tool valuable, 97\\% wanted it to continue, 98\\% reported unchanged or improved relationships with their clinician, and none of the providers in the small pilot reported worsening workflow or relationships with patients.\nConclusions Patients and care partners reported potential safety concerns in about one-quarter of reports, often resulting in a change to the record},\n\tlanguage = {en},\n\tnumber = {4},\n\turldate = {2026-07-15},\n\tjournal = {BMJ Quality \\& Safety},\n\tauthor = {Bell, Sigall K and Gerard, Macda and Fossa, Alan and Delbanco, Tom and Folcarelli, Patricia H and Sands, Kenneth E and Sarnoff Lee, Barbara and Walker, Jan},\n\tmonth = apr,\n\tyear = {2017},\n\tpages = {312--322},\n}\n\n","author_short":["Bell, S. K","Gerard, M.","Fossa, A.","Delbanco, T.","Folcarelli, P. H","Sands, K. E","Sarnoff Lee, B.","Walker, J."],"key":"bell_patient_2017","id":"bell_patient_2017","bibbaseid":"bell-gerard-fossa-delbanco-folcarelli-sands-sarnofflee-walker-apatientfeedbackreportingtoolforopennotesimplicationsforpatientcliniciansafetyandqualitypartnerships-2017","role":"author","urls":{"Paper":"https://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2016-006020"},"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://api.zotero.org/users/14490939/collections/3A9VVSJM/items?key=yHpYkAVpz4F3eH8gwwwXED4K&format=bibtex&limit=100","dataSources":["d7L6kF2XgMjvBF4Lx","RyfXFmXNStRFjPdoe"],"keywords":[],"search_terms":["patient","feedback","reporting","tool","opennotes","implications","patient","clinician","safety","quality","partnerships","bell","gerard","fossa","delbanco","folcarelli","sands","sarnoff lee","walker"],"title":"A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships","year":2017}