Caregiver Perspectives Regarding Patient Safety During Pediatric Hospitalization: A Qualitative Analysis

Approximately 1 in 10 children admitted to a hospital experience an adverse event, and of these events, approximately 44% can be considered to be preventable. It has been shown that focusing on family- and patient-centered care can improve both the quality of care and reduce harm. Little has been published about the perspectives of families regarding their roles in safety. The purpose of this study was to gain a deeper understanding of family experiences and priorities regarding their child's safety while in the hospital.

Our team conducted semistructured interviews among caregivers in either a tertiary pediatric hospital or the pediatric unit of a general hospital to explore perceptions and experiences regarding pediatric patient safety during their hospital stay. Purposive sampling was used to promote the inclusion of families who differed by experience with past hospitalizations, complexity of child disease status, family structure, and culture. All semistructured interviews were conducted virtually and transcribed verbatim. Transcripts were analyzed using emergent thematic analysis.

Twenty-five interviews were conducted, from which 2 primary domains emerged: (1) Safety Climate, which describes elements of the in-hospital environment that contribute to both physical and psychological safety such as protective policy/procedures related to risk mitigation, staff behaviors and attitudes, collaboration with families and information sharing, and respect for patient dignity and family inclusion in care; and (2) Family Integration and Future Directions, which describes caregivers' preference for accessible and inclusive channels and pathways to both learn about safety and report safety concerns.

Caregivers of pediatric patients value family integration into patient safety and conceptualize safety in a manner that extends beyond freedom from harm. Staff attitudes and behaviors are strong contributors to a feeling of safety. This knowledge can provide a foundation for future codesign of strategies to improve patient and family partnership in safety.