Families as Partners in Hospital Error and Adverse Event Surveillance

Area of Science:

• Pediatric patient safety
• Healthcare quality improvement
• Medical error detection

Background:

• Medical errors and adverse events (AEs) are prevalent in pediatric hospital settings.
• Current safety surveillance relies heavily on clinician reports, often missing patient and family perspectives.
• There is a need to explore novel mechanisms for comprehensive incident detection.

Purpose of the Study:

• To compare error and adverse event (AE) rates identified through systematic review with and without family reporting.
• To compare rates reported by families versus clinicians.
• To compare rates reported by families versus existing hospital incident reports.

Main Methods:

• A prospective cohort study involving 989 pediatric patients and their caregivers across 4 US centers.
• Utilized weekly and discharge Family Safety Interviews (FSIs) alongside traditional clinician and medical record reviews.
• Employed Poisson regression with generalized estimating equations for rate analysis.

Main Results:

• Family reporting increased overall error rates by 1.2-fold and AE rates by 1.1-fold.
• Families identified 8 AEs not found through other surveillance methods, including 7 preventable AEs.
• Family-reported error and AE rates were substantially higher (5.0-fold and 2.9-fold, respectively) than hospital incident report rates.

Conclusions:

• Family input provides unique and critical information for hospital safety surveillance.
• Integrating family reporting mechanisms can significantly enhance the detection of medical errors and AEs.
• This approach facilitates better design and assessment of interventions to improve pediatric patient safety.