PMID- 26928413 OWN - NLM STAT- MEDLINE DCOM- 20160816 LR - 20220317 IS - 2168-6211 (Electronic) IS - 2168-6203 (Print) IS - 2168-6203 (Linking) VI - 170 IP - 4 DP - 2016 Apr TI - Parent-Reported Errors and Adverse Events in Hospitalized Children. PG - e154608 LID - 10.1001/jamapediatrics.2015.4608 [doi] AB - IMPORTANCE: Limited data exist regarding the incidence and nature of patient- and family-reported medical errors, particularly in pediatrics. OBJECTIVE: 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 (AEs). DESIGN, SETTING, AND PARTICIPANTS: We conducted a prospective cohort study from May 2013 to October 2014 within 2 general pediatric units at a children's hospital. Included in the study were English-speaking parents (N = 471) of randomly selected inpatients (ages 0-17 years) prior to discharge. Parents reported via written survey whether their child experienced any safety incidents during hospitalization. Two physician reviewers classified incidents as medical errors, other quality issues, or exclusions (kappa = 0.64; agreement = 78%). They then categorized medical errors as harmful (ie, preventable AEs) or nonharmful (kappa = 0.77; agreement = 89%). We analyzed errors/AEs using descriptive statistics and explored predictors of parent-reported errors using bivariate statistics. We subsequently reviewed patient medical records to determine the number of parent-reported errors that were present in the medical record. We obtained demographic/clinical data from hospital administrative records. MAIN OUTCOMES AND MEASURES: Medical errors and preventable AEs. RESULTS: The mean (SD) age of the 383 parents surveyed was 36.6 (8.9) years; most respondents (n = 266) were female. Of 383 parents surveyed (81% response rate), 34 parents (8.9%) reported 37 safety incidents. Among these, 62% (n = 23, 6.0 per 100 admissions) were determined to be medical errors on physician review, 24% (n = 9) were determined to be other quality problems, and 14% (n = 5) were determined to be neither. Thirty percent (n = 7, 1.8 per 100 admissions) of medical errors caused harm (ie, were preventable AEs). On bivariate analysis, children with medical errors appeared to have longer lengths of stay (median [interquartile range], 2.9 days [2.2-6.9] vs 2.5 days [1.9-4.1]; P = .04), more often had a metabolic (14.3% vs 3.0%; P = .04) or neuromuscular (14.3% vs 3.6%; P = .05) condition, and more often had an annual household income greater than $100,000 (38.1% vs 30.1%; P = .06) than those without errors. Fifty-seven percent (n = 13) of parent-reported medical errors were also identified on subsequent medical record review. CONCLUSIONS AND RELEVANCE: Parents frequently reported errors and preventable AEs, many of which were not otherwise documented in the medical record. Families are an underused source of data about errors, particularly preventable AEs. Hospitals may wish to consider incorporating family reports into routine safety surveillance systems. FAU - Khan, Alisa AU - Khan A AD - Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts2Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. FAU - Furtak, Stephannie L AU - Furtak SL AD - Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts. FAU - Melvin, Patrice AU - Melvin P AD - Center for Patient Safety and Quality Research, Boston Children's Hospital, Boston, Massachusetts. FAU - Rogers, Jayne E AU - Rogers JE AD - Department of Nursing, Boston Children's Hospital, Boston, Massachusetts. FAU - Schuster, Mark A AU - Schuster MA AD - Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts2Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. FAU - Landrigan, Christopher P AU - Landrigan CP AD - Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts2Department of Pediatrics, Harvard Medical School, Boston, Massachusetts5Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts. LA - eng GR - K12 HS022986/HS/AHRQ HHS/United States GR - T32 HS000063/HS/AHRQ HHS/United States GR - K12HS022986/HS/AHRQ HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. DEP - 20160404 PL - United States TA - JAMA Pediatr JT - JAMA pediatrics JID - 101589544 SB - IM MH - Adolescent MH - Adult MH - Child MH - Child, Hospitalized/statistics & numerical data MH - Child, Preschool MH - Cohort Studies MH - Female MH - Hospitals, Pediatric MH - Humans MH - Incidence MH - Infant MH - Length of Stay MH - Male MH - Medical Errors/*statistics & numerical data MH - Parents MH - *Patient Safety MH - Prospective Studies PMC - PMC5336322 MID - NIHMS847322 COIS- Conflict of Interest Disclosures: Dr Landrigan has served as a paid consultant for Virgin Pulse to help develop a sleep and health program. Dr Landrigan has served as an expert witness in cases regarding patient safety and sleep deprivation. No other disclosures were reported. EDAT- 2016/03/02 06:00 MHDA- 2016/08/17 06:00 PMCR- 2017/04/04 CRDT- 2016/03/02 06:00 PHST- 2016/03/02 06:00 [entrez] PHST- 2016/03/02 06:00 [pubmed] PHST- 2016/08/17 06:00 [medline] PHST- 2017/04/04 00:00 [pmc-release] AID - 2498405 [pii] AID - 10.1001/jamapediatrics.2015.4608 [doi] PST - ppublish SO - JAMA Pediatr. 2016 Apr;170(4):e154608. doi: 10.1001/jamapediatrics.2015.4608. Epub 2016 Apr 4.