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2. Families as Partners in Hospital Error and Adverse Event Surveillance

Author

Khan, Alisa, Coffey, Maitreya, Litterer, Katherine P, Baird, Jennifer D, Furtak, Stephannie L, Garcia, Briana M, Ashland, Michele A, Calaman, Sharon, Kuzma, Nicholas C, O’Toole, Jennifer K, Patel, Aarti, Rosenbluth, Glenn, Destino, Lauren A, Everhart, Jennifer L, Good, Brian P, Hepps, Jennifer H, Dalal, Anuj K, Lipsitz, Stuart R, Yoon, Catherine S, Zigmont, Katherine R, Srivastava, Rajendu, Starmer, Amy J, Sectish, Theodore C, Spector, Nancy D, West, Daniel C, Landrigan, Christopher P, Allair, Brenda K, Alminde, Claire, Alvarado-Little, Wilma, Atsatt, Marisa, Aylor, Megan E, Bale, James F, Balmer, Dorene, Barton, Kevin T, Beck, Carolyn, Bismilla, Zia, Blankenberg, Rebecca L, Chandler, Debra, Choudhary, Amanda, Christensen, Eileen, Coghlan-McDonald, Sally, Cole, F Sessions, Corless, Elizabeth, Cray, Sharon, Da Silva, Roxi, Dahale, Devesh, Dreyer, Benard, Growdon, Amanda S, Gubler, LeAnn, Guiot, Amy, Harris, Roben, Haskell, Helen, Kocolas, Irene, Kruvand, Elizabeth, Lane, Michele Marie, Langrish, Kathleen, Ledford, Christy JW, Lewis, Kheyandra, Lopreiato, Joseph O, Maloney, Christopher G, Mangan, Amanda, Markle, Peggy, Mendoza, Fernando, Micalizzi, Dale Ann, Mittal, Vineeta, Obermeyer, Maria, O’Donnell, Katherine A, Ottolini, Mary, Patel, Shilpa J, Pickler, Rita, Rogers, Jayne Elizabeth, Sanders, Lee M, Sauder, Kimberly, Shah, Samir S, Sharma, Meesha, Simpkin, Arabella, Subramony, Anupama, Thompson, E Douglas, Trueman, Laura, Trujillo, Tanner, Turmelle, Michael P, Warnick, Cindy, Welch, Chelsea, White, Andrew J, Wien, Matthew F, Winn, Ariel S, Wintch, Stephanie, Wolf, Michael, Yin, H Shonna, and Yu, Clifton E

Subjects
Clinical Trials and Supportive Activities, Clinical Research, Pediatric, Patient Safety, Good Health and Well Being, Adult, Child, Child, Hospitalized, Cohort Studies, Family, Female, Hospitals, Pediatric, Humans, Male, Medical Errors, Prospective Studies, United States, the Patient and Family Centered I-PASS Study Group, Paediatrics and Reproductive Medicine, Pediatrics
Abstract

ImportanceMedical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection.ObjectiveTo compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports.Design, setting, and participantsWe conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%-90%; κ, 0.50-0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient.Main outcomes and measuresError and AE rates.ResultsOverall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26-40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95% CI, 1.1-1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95% CI, 1.0-1.2; P = .006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95% CI, .5-1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95% CI, 0.8-2.2). Family-reported error rates were 5.0-fold (95% CI, 1.9-13.0) higher and AE rates 2.9-fold (95% CI, 1.2-6.7) higher than hospital incident report rates.Conclusions and relevanceFamilies provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better design and assessment of interventions to improve safety.

Published
2017

3. Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program

Author

Landrigan, Christopher P., Spector, Nancy D., Starmer, Amy J., Sectish, Theodore C., Srivastava, Rajendu, West, Daniel C., Menon, Aravind Ajakumar, Ali, Arshia, Allair, Brenda K., Allen, April D., Almaddah, Nureddin, Alminde, Claire, Alvarado-Little, Wilma, Anson, Elizabeth, Ashland, Michele, Atsatt, Marisa, Aylor, Megan, Baird, Jennifer D., Bale, James F., Jr, Balmer, Dorene, Barber, Aisha, Barton, Kevin, Bates, Kimberly, Beck, Carolyn, Berchelmann, Kathleen, Bhan, Renuka, Bismilla, Zia, Blankenburg, Rebecca L., Boa-Hocbo, Aileen, Bordin-Wosk, Talya, Brooks, Michelle, Calaman, Sharon, Campe, Julie, Campos, Maria Lucia, Chandler, Debra, Cheung, Yvonne, Choudhary, Amanda, Christensen, Eileen, Clark, Katherine, Coffey, Maitreya, Coghlan-McDonald, Sally, Cohen, Ellen, Cole, F. Sessions, Corless, Elizabeth, Cray, Sharon, Da Silva, Roxi, Dahale, Devesh, Dalal, Anuj K., Destino, Lauren A., Doroshow, Jonathan, Dreyer, Benard, duPont, Katharine, Eagle, Steven, Edgar-Zarate, Courtney, Etzenhouser, Angie, Everhart, Jennifer L., Feraco, Angela M., Ferrer, Alexandra, Galardy, Paul, Garcia, Briana M., Gaspar-Oishi, Maria, Goldstein, Jenna, Good, Brian P., Graham, Dionne A, Growdon, Amanda S., Gubler, LeAnn, Guiot, Amy, Hanlon, Charin, Hanna-Attisha, Mona, Harris, Roben, Haskell, Helen, Hecht, Melvyn, Hehn, Rebecca S, Held, Justin, Hepps, Jennifer H., Hillier, Debra, Hiraoka, Mark, Howell, Eric, Hrach, Christine, Hughes, Helen, Huskins, Charles, Kaatz, Scott, Kanala, Vishnu, Kantrowitz, Michael, Kaplan, Peter, Kashiwagi, Deanne, Kaul, Rajat, Keohane, Carol A., Kern, Jeremy, Khan, Alisa, Khan, Nazia Naz S., Kitch, Barry, Kocolas, Irene, Kothari, Lara, Kruvand, Elizabeth, Kuzma, Nicholas, Lacy, Mary, Lane, Michele, Langrish, Kate, Ledford, Christy J.W., LeRoux, Laura, Lewis, Kheyandra, Lipsitz, Stuart, Litterer, Katherine P., Lopreiato, Joseph O., Lyons, Aimee, Mack, Avram, Mallouk, Meghan, Maloney, Christopher G., Mangan, Amanda, Mann, Keith, Markle, Peggy, Marrese, Christine, Marseille, David, Maynard, Greg, Mehta, Bijal, Mendoza, Fernando, Mercer, Alexandra N., Micalizzi, Dale, Mims, Lisa, Mittal, Vineeta, Mueller, Stephanie, Ngo, Thuy L., Nolan, Ann, Nyenpan, Christopher, Obermeyer, Maria, O'Donnell, Katherine, O'Toole, Jennifer K., Ottolini, Mary, Owolabi, Mobola, Patel, Aarti, Patel, Rajesh, Patel, Shilpa J., Perron, Catherine, Pickler, Rita, Popa, Alina, Reppert, Patrick, Riss, Robert, Roesch, Justin, Rogers, Jayne E., Rosenbluth, Glenn, Rothschild, Jeffrey M., Sanders, Lee, Sauder, Kimberly, Schnipper, Jeff, Schnock, Kumiko O, Scholtz, Amy, Seltz, Barry, Serra, Theresa, Serwint, Janet, Shah, Samir, Sharma, Meesha, Sheppard, Kathleen, Simpkin, Arabella, Sloan, Karin A, Solan, Lauren G., Southgate, Michael W, Spackman, Jaime Blank, Stevens, Scott M., Stevenson, Adam, Stevenson, Windy, Subramony, Anupama, Surkis, William, Thangarasu, Sudhagar, Thompson, E. Douglas, Toole, Cheryl, Trueman, Laura, Trujillo, Tanner, Tse, Lisa, Turmelle, Michael P., Vaniawala, Vishwas, Wagner, Tamara, Warnick, Cindy, Webster, John, Webster, Mary, Weinerman, Adina, Welch, Chelsea, White, Andrew J., Wien, Matthew F., Winn, Ariel S., Wintch, Stephanie, Yin, H. Shonna, Yoon, Catherine S., Yu, Clifton E., Zampino, Dominick, and Zigmont, Katherine R.

Published
2017
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12. Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study

Author

Khan, Alisa, primary, Spector, Nancy D, additional, Baird, Jennifer D, additional, Ashland, Michele, additional, Starmer, Amy J, additional, Rosenbluth, Glenn, additional, Garcia, Briana M, additional, Litterer, Katherine P, additional, Rogers, Jayne E, additional, Dalal, Anuj K, additional, Lipsitz, Stuart, additional, Yoon, Catherine S, additional, Zigmont, Katherine R, additional, Guiot, Amy, additional, O’Toole, Jennifer K, additional, Patel, Aarti, additional, Bismilla, Zia, additional, Coffey, Maitreya, additional, Langrish, Kate, additional, Blankenburg, Rebecca L, additional, Destino, Lauren A, additional, Everhart, Jennifer L, additional, Good, Brian P, additional, Kocolas, Irene, additional, Srivastava, Rajendu, additional, Calaman, Sharon, additional, Cray, Sharon, additional, Kuzma, Nicholas, additional, Lewis, Kheyandra, additional, Thompson, E Douglas, additional, Hepps, Jennifer H, additional, Lopreiato, Joseph O, additional, Yu, Clifton E, additional, Haskell, Helen, additional, Kruvand, Elizabeth, additional, Micalizzi, Dale A, additional, Alvarado-Little, Wilma, additional, Dreyer, Benard P, additional, Yin, H Shonna, additional, Subramony, Anupama, additional, Patel, Shilpa J, additional, Sectish, Theodore C, additional, West, Daniel C, additional, and Landrigan, Christopher P, additional

Published
2018
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15. Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program

Author

Starmer, Amy J., primary, Spector, Nancy D., additional, West, Daniel C., additional, Srivastava, Rajendu, additional, Sectish, Theodore C., additional, Landrigan, Christopher P., additional, Starmer, Amy J., additional, Menon, Aravind Ajakumar, additional, Ali, Arshia, additional, Allair, Brenda K., additional, Allen, April D., additional, Almaddah, Nureddin, additional, Alminde, Claire, additional, Alvarado-Little, Wilma, additional, Anson, Elizabeth, additional, Ashland, Michele, additional, Atsatt, Marisa, additional, Aylor, Megan, additional, Baird, Jennifer D., additional, Bale, James F., additional, Balmer, Dorene, additional, Barber, Aisha, additional, Barton, Kevin, additional, Bates, Kimberly, additional, Beck, Carolyn, additional, Berchelmann, Kathleen, additional, Bhan, Renuka, additional, Bismilla, Zia, additional, Blankenburg, Rebecca L., additional, Boa-Hocbo, Aileen, additional, Bordin-Wosk, Talya, additional, Brooks, Michelle, additional, Calaman, Sharon, additional, Campe, Julie, additional, Campos, Maria Lucia, additional, Chandler, Debra, additional, Cheung, Yvonne, additional, Choudhary, Amanda, additional, Christensen, Eileen, additional, Clark, Katherine, additional, Coffey, Maitreya, additional, Coghlan-McDonald, Sally, additional, Cohen, Ellen, additional, Cole, F. Sessions, additional, Corless, Elizabeth, additional, Cray, Sharon, additional, Da Silva, Roxi, additional, Dahale, Devesh, additional, Dalal, Anuj K., additional, Destino, Lauren A., additional, Doroshow, Jonathan, additional, Dreyer, Benard, additional, duPont, Katharine, additional, Eagle, Steven, additional, Edgar-Zarate, Courtney, additional, Etzenhouser, Angie, additional, Everhart, Jennifer L., additional, Feraco, Angela M., additional, Ferrer, Alexandra, additional, Galardy, Paul, additional, Garcia, Briana M., additional, Gaspar-Oishi, Maria, additional, Goldstein, Jenna, additional, Good, Brian P., additional, Graham, Dionne A, additional, Growdon, Amanda S., additional, Gubler, LeAnn, additional, Guiot, Amy, additional, Hanlon, Charin, additional, Hanna-Attisha, Mona, additional, Harris, Roben, additional, Haskell, Helen, additional, Hecht, Melvyn, additional, Hehn, Rebecca S, additional, Held, Justin, additional, Hepps, Jennifer H., additional, Hillier, Debra, additional, Hiraoka, Mark, additional, Howell, Eric, additional, Hrach, Christine, additional, Hughes, Helen, additional, Huskins, Charles, additional, Kaatz, Scott, additional, Kanala, Vishnu, additional, Kantrowitz, Michael, additional, Kaplan, Peter, additional, Kashiwagi, Deanne, additional, Kaul, Rajat, additional, Keohane, Carol A., additional, Kern, Jeremy, additional, Khan, Alisa, additional, Khan, Nazia Naz S., additional, Kitch, Barry, additional, Kocolas, Irene, additional, Kothari, Lara, additional, Kruvand, Elizabeth, additional, Kuzma, Nicholas, additional, Lacy, Mary, additional, Lane, Michele, additional, Langrish, Kate, additional, Ledford, Christy J.W., additional, LeRoux, Laura, additional, Lewis, Kheyandra, additional, Lipsitz, Stuart, additional, Litterer, Katherine P., additional, Lopreiato, Joseph O., additional, Lyons, Aimee, additional, Mack, Avram, additional, Mallouk, Meghan, additional, Maloney, Christopher G., additional, Mangan, Amanda, additional, Mann, Keith, additional, Markle, Peggy, additional, Marrese, Christine, additional, Marseille, David, additional, Maynard, Greg, additional, Mehta, Bijal, additional, Mendoza, Fernando, additional, Mercer, Alexandra N., additional, Micalizzi, Dale, additional, Mims, Lisa, additional, Mittal, Vineeta, additional, Mueller, Stephanie, additional, Ngo, Thuy L., additional, Nolan, Ann, additional, Nyenpan, Christopher, additional, Obermeyer, Maria, additional, O'Donnell, Katherine, additional, O'Toole, Jennifer K., additional, Ottolini, Mary, additional, Owolabi, Mobola, additional, Patel, Aarti, additional, Patel, Rajesh, additional, Patel, Shilpa J., additional, Perron, Catherine, additional, Pickler, Rita, additional, Popa, Alina, additional, Reppert, Patrick, additional, Riss, Robert, additional, Roesch, Justin, additional, Rogers, Jayne E., additional, Rosenbluth, Glenn, additional, Rothschild, Jeffrey M., additional, Sanders, Lee, additional, Sauder, Kimberly, additional, Schnipper, Jeff, additional, Schnock, Kumiko O, additional, Scholtz, Amy, additional, Seltz, Barry, additional, Serra, Theresa, additional, Serwint, Janet, additional, Shah, Samir, additional, Sharma, Meesha, additional, Sheppard, Kathleen, additional, Simpkin, Arabella, additional, Sloan, Karin A, additional, Solan, Lauren G., additional, Southgate, Michael W, additional, Spackman, Jaime Blank, additional, Stevens, Scott M., additional, Stevenson, Adam, additional, Stevenson, Windy, additional, Subramony, Anupama, additional, Surkis, William, additional, Thangarasu, Sudhagar, additional, Thompson, E. Douglas, additional, Toole, Cheryl, additional, Trueman, Laura, additional, Trujillo, Tanner, additional, Tse, Lisa, additional, Turmelle, Michael P., additional, Vaniawala, Vishwas, additional, Wagner, Tamara, additional, Warnick, Cindy, additional, Webster, John, additional, Webster, Mary, additional, Weinerman, Adina, additional, Welch, Chelsea, additional, White, Andrew J., additional, Wien, Matthew F., additional, Winn, Ariel S., additional, Wintch, Stephanie, additional, Yin, H. Shonna, additional, Yoon, Catherine S., additional, Yu, Clifton E., additional, Zampino, Dominick, additional, and Zigmont, Katherine R., additional

Published
2017
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20. I-PASS Handoff Curriculum: Medical Student Workshop

Author

O'Toole, Jennifer, primary, Calaman, Sharon, additional, Everhart, Jennifer, additional, Bismilla, Zia, additional, Good, Brian, additional, Guiot, Amy, additional, Johnstone, Noelle, additional, Nilforoshan, Vahideh, additional, Noble, Elizabeth, additional, Rosenbluth, Glenn, additional, Schwartz, Sarah, additional, Solan, Lauren, additional, Tse, Lisa, additional, West, Daniel, additional, Weiser, Jason, additional, Landrigan, Christopher, additional, Sectish, Theodore, additional, Srivastava, Rajendu, additional, Starmer, Amy, additional, and Spector, Nancy, additional

Published
2014
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23. Closing the Gap: A Needs Assessment of Medical Students and Handoff Training

Author

O'Toole, Jennifer K., primary, Stevenson, Adam T., additional, Good, Brian P., additional, Guiot, Amy B., additional, Solan, Lauren G., additional, Tse, Lisa L., additional, Landrigan, Christopher P., additional, Sectish, Theodore C., additional, Srivastava, Rajendu, additional, Starmer, Amy J., additional, and Spector, Nancy D., additional

Published
2013
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25. Rapid Adoption of Lactobacillus rhamnosus GG for Acute Gastroenteritis

Author

Parker, Michelle W., primary, Schaffzin, Joshua K., additional, Lo Vecchio, Andrea, additional, Yau, Connie, additional, Vonderhaar, Karen, additional, Guiot, Amy, additional, Brinkman, William B., additional, White, Christine M., additional, Simmons, Jeffrey M., additional, Gerhardt, Wendy E., additional, Kotagal, Uma R., additional, and Conway, Patrick H., additional

Published
2013
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28. Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios.

Author

Khan A, Patel SJ, Anderson M, Baird JD, Johnson TM, Liss I, Graham DA, Calaman S, Fegley AE, Goldstein J, O'Toole JK, Rosenbluth G, Alminde C, Bass EJ, Bismilla Z, Caruth M, Coghlan-McDonald S, Cray S, Destino LA, Dreyer BP, Everhart JL, Good BP, Guiot AB, Haskell H, Hepps JH, Knighton AJ, Kocolas I, Kuzma NC, Lewis K, Litterer KP, Kruvand E, Markle P, Micalizzi DA, Patel A, Rogers JE, Subramony A, Vara T, Yin HS, Sectish TC, Srivastava R, Starmer AJ, West DC, Spector ND, and Landrigan CP

Subjects
Humans, Child, Parents, Hospitals, Teaching, Communication, Language, Mentors, Teaching Rounds
Abstract

Background and Objectives: Patient and Family Centered I-PASS (PFC I-PASS) emphasizes family and nurse engagement, health literacy, and structured communication on family-centered rounds organized around the I-PASS framework (Illness severity-Patient summary-Action items-Situational awareness-Synthesis by receiver). We assessed adherence, safety, and experience after implementing PFC I-PASS using a novel "Mentor-Trio" implementation approach with multidisciplinary parent-nurse-physician teams coaching sites., Methods: Hybrid Type II effectiveness-implementation study from 2/29/19-3/13/22 with ≥3 months of baseline and 12 months of postimplementation data collection/site across 21 US community and tertiary pediatric teaching hospitals. We conducted rounds observations and surveyed nurses, physicians, and Arabic/Chinese/English/Spanish-speaking patients/parents., Results: We conducted 4557 rounds observations and received 2285 patient/family, 1240 resident, 819 nurse, and 378 attending surveys. Adherence to all I-PASS components, bedside rounding, written rounds summaries, family and nurse engagement, and plain language improved post-implementation (13.0%-60.8% absolute increase by item), all P < .05. Except for written summary, improvements sustained 12 months post-implementation. Resident-reported harms/1000-resident-days were unchanged overall but decreased in larger hospitals (116.9 to 86.3 to 72.3 pre versus early- versus late-implementation, P = .006), hospitals with greater nurse engagement on rounds (110.6 to 73.3 to 65.3, P < .001), and greater adherence to I-PASS structure (95.3 to 73.6 to 72.3, P < .05). Twelve of 12 measures of staff safety climate improved (eg, "excellent"/"very good" safety grade improved from 80.4% to 86.3% to 88.0%), all P < .05. Patient/family experience and teaching were unchanged., Conclusions: Hospitals successfully used Mentor-Trios to implement PFC I-PASS. Family/nurse engagement, safety climate, and harms improved in larger hospitals and hospitals with better nurse engagement and intervention adherence. Patient/family experience and teaching were not affected., (Copyright © 2024 by the American Academy of Pediatrics.)

Published
2024
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