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How might health services capture patient-reported safety concerns in a hospital setting? An exploratory pilot study of three mechanisms
  1. Jane Kathryn O'Hara1,2,
  2. Gerry Armitage2,3,
  3. Caroline Reynolds2,
  4. Claire Coulson4,
  5. Liz Thorp2,
  6. Ikhlaq Din2,
  7. Ian Watt5,
  8. John Wright2,6
  1. 1Leeds Institute of Medical Education, University of Leeds, Leeds, UK
  2. 2Quality & Safety Research, Bradford Institute for Health Research, Bradford, UK
  3. 3School of Health, University of Bradford, Bradford, UK
  4. 4Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  5. 5Department of Health Sciences, University of York, York, UK
  6. 6Royal Infirmary Bradford, Department of Epidemiology and Public Health, Bradford, UK
  1. Correspondence to Dr Jane Kathryn O'Hara, Leeds Institute of Medical Education, University of Leeds, Level 7, Worsley Building, Leeds LS2 9NL, UK; jane.o'hara@bthft.nhs.uk

Abstract

Introduction Emergent evidence suggests that patients can identify and report safety issues while in hospital. However, little is known about the best method for collecting information from patients about safety concerns. This study presents an exploratory pilot of three mechanisms for collecting data on safety concerns from patients during their hospital stay.

Method Three mechanisms for capturing safety concerns were coproduced with healthcare professionals and patients, before being tested in an exploratory trial using cluster randomisation at the ward level. Nine wards participated, with each mechanism being tested over a 3-month study period. Patients were asked to feed back safety concerns via the mechanism on their ward (interviewing at their bedside, paper-based form or patient safety ‘hotline’). Safety concerns were subjected to a two-stage review process to identify those that would meet the definition of a patient safety incident. Differences between mechanisms on a range of outcomes were analysed using inferential statistics. Safety concerns were thematically analysed to develop reporting categories.

Results 178 patients were recruited. Patients in the face-to-face interviewing condition provided significantly more safety concerns per patient (1.91) compared with the paper-based form (0.92) and the patient safety hotline (0.43). They were also significantly more likely to report one or more concerns, with 64% reporting via the face-to-face mechanism, compared with 41% via the paper-based form and 19% via the patient safety hotline. No mechanism differed significantly in the number of classified patient safety incidents or physician-rated preventability and severity.

Discussion Interviewing at the patient's bedside is likely to be the most effective means of gathering safety concerns from inpatients, potentially providing an opportunity for health services to gather patient feedback about safety from their perspective.

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