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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'


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.

  • Incident reporting
  • Patient-centred care
  • Patient safety

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  • Twitter Follow Jane O'Hara at @janekohara

  • Contributors JOH drafted the manuscript. JOH and GA were responsible for the design and conduct of the study. CR managed the process of review for patient-reported safety concerns and the dataset as a whole. JW and IW developed the protocol and had an overall view of the project. CR, CC, LT and ID were involved in the conduct of the study and recruited patients into the study. All authors reviewed and edited the manuscript and agreed on the final draft.

  • Funding This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (RP-PG-0108-10049). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Ethics approval NHS REC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We are happy to share anonymised data.