A Coproduced Family Reporting Intervention to Improve Safety Surveillance and Reduce Disparities
Year: 2024
Type: article
Abstract: OBJECTIVES: Examine family safety-reporting after implementing a parent-nurse-physician-leader coproduced, health literacy-informed, family safety-reporting intervention for hospitalized families of children with medical complexity. METHODS: We implemented an English and Spanish mobile family-safety-reporting tool, staff and family education, and process for sharing comments with unit leaders on a dedicated inpatient complex care service at a pediatric hospital. Families shared safety concerns via predischarge surveys (baseline and intervention) and mobile tool (intervention). Three physicians with patient safety expertise classified events. We compared safety-reporting baseline (via survey) versus intervention (via survey and/or mobile tool) with generalized estimating equations and sub-analyzed data by COVID-19-era and educational attainment. We also compared mobile tool-detected event rates with hospital voluntary incident reporting. RESULTS: 232 baseline and 208 intervention parents participated (78.2% consented); 29.5% of baseline families versus 38.2% of intervention families reported safety concerns (P = .09). Adjusted odds ratio (95% CI) of families reporting safety concerns intervention versus baseline was 1.6 (1.0-2.6) overall, 2.6 (1.3-5.4) for those with < college education, and 3.1 (1.3-7.3) in the COVID-19-era subgroup. Safety concerns reported via mobile tool (34.6% of enrolled parents) included 42 medical errors, 43 nonsafety-related quality issues, 11 hazards, and 4 other. 15% of mobile tool concerns were also detected with voluntary incident reporting. CONCLUSIONS: Family safety-reporting was unchanged overall after implementing a mobile reporting tool, though reporting increased among families with lower educational attainment and during the COVID-19 pandemic. The tool identified many events not otherwise captured by staff-only voluntary incident reporting. Hospitals should proactively engage families in reporting to improve safety, quality, and equity.
Source: PEDIATRICS
Authors: Alisa Khan, Jennifer Baird, Sangeeta Mauskar, Helen W. Haskell, Alexandra N. Habibi, Tiffany Ngo, Alexandra Aldarondo, Jay G. Berry, Katherine L. Copp, Jessica P. Liu, Brynn Elder, Kathryn P. Gray, Karen Hennessy, Kate E. Humphrey, Donna Luff, Nandini Mallick, Susan Matherson, Amanda G. McGeachey, Patrice Melvin, Amy L. Pinkham, Bianca Quiñones-Pérez, Jayne Rogers, Sara J. Singer, Patricia A. Stoeck, Sara L. Toomey, K. Viswanath, Jayme L. Wilder, Mark A. Schuster, Christopher P. Landrigan
Institutions: Children's Hospital of Los Angeles, New York University, George Mason University, University of Minnesota, Harvard University, MaineHealth, Barbara Bush Children’s Hospital, Boston Children's Hospital, Stanford Medicine, Stanford University, Dana-Farber Cancer Institute, Kaiser Permanente Bernard J. Tyson School of Medicine, Brigham and Women's Hospital
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Awards: G1828190173, G249691623, G3583377019
OpenAlex ID: W4402166519