We collected over 100 written patient narratives on how they make sense of their involvement in hospital care. We identified 4 involvement patterns indicative of the dynamic interchange between patients, professionals and the health care system:
- Agreement between patient and professional about the kind and degree of involvement;
- Patients have higher involvement demands than expected by professionals;
- Patients have lower involvement demands than expected;
- Patient involvement is unarticulated or uncertain.
As these patterns are not fixed, staff and patients can be trained to reflexively steer toward patterns that result in higher quality and safety of care.