Unfortunately, medical errors occur in hospitalized patients, including children. All hospitals have procedures in place to report those errors and minimize their recurrence. A new study has found that parents of hospitalized children can be effective in reporting medical errors and preventable adverse events. Moreover, they may discover errors overlooked by hospital personnel. The findings were published online on February 29 in the journal JAMA Pediatrics.
The study authors note that the medical literature contains only limited data regarding the incidence and nature of patient- and family-reported medical errors, particularly in pediatrics. Therefore, they conducted a study to determine the frequency with which parents experience patient safety incidents and the proportion of reported incidents that meet standard definitions of medical errors and preventable adverse events.
From May 2013 through October 2014, the researchers conducted a prospective (forward-looking) study in two general pediatric units at a children’s hospital. Included in the study were English-speaking parents (471) of randomly selected inpatients (age: 0-17 years) prior to discharge. Via a written survey, the parents reported whether their child experienced any safety incidents during hospitalization. Two physician reviewers classified incidents as medical errors, other quality issues, or exclusions. They then categorized medical errors as harmful (i.e., preventable adverse events or non-harmful. The reported errors were subjected to statistical analysis and then reviewed patient medical records to determine the number of parent-reported errors that were present in the medical record. They obtained demographic/clinical data from hospital administrative records.
The average age of the 383 parents surveyed (81% response rate) was 36.6 (8.9) years; most of them (266) were female. Of 383 parents surveyed, 34 (8.9%) reported 37 safety incidents. Among these, 62% (23; 6.0 per 100 admissions) were determined to be medical errors on physician review, 24% (9) were determined to be other quality problems, and 14% (5) were determined to be neither. About one-third (30%; 7, 1.8 per 100 admissions) of medical errors caused harm (i.e., were preventable adverse events. Statistical analysis revealed that children with medical errors appeared to have longer lengths of stay (average 2.9 days vs. average 2.5 days), more often had a metabolic (14.3% vs. 3.0%) or neuromuscular (14.3% vs. 3.6%) condition, and more often had an annual household income greater than $100 000 (38.1% vs. 30.1%) than those without errors. The majority (57% (13) of parent-reported medical errors were also identified on subsequent medical record review.
The authors concluded that parents frequently reported errors and preventable adverse events, many of which were not otherwise documented in the medical record. They stressed that families are an underused source of data regarding errors, particularly preventable adverse events. The suggested that hospitals should consider incorporating family reports into routine safety surveillance systems.