Adverse event reviews in healthcare: what matters to patients and their family? A qualitative study exploring the perspective of patients and family

Abstract

ObjectivesExplore what ‘good’ patient and family involvement in healthcare adverse event reviews may involve.DesignData was collected using semi-structured telephone interviews. Interview transcripts were analysed using an inductive thematic approach.SettingNHS Scotland.Participants19 interviews were conducted with patients who had experienced an adverse event during the provision of their healthcare or their family member.ResultsFour key themes were derived from these interviews: trauma, communication, learning and litigation.ConclusionsThere are many advantages of actively involving patients and their families in adverse event reviews. An open, collaborative, person-centred approach which listens to, and involves, patients and their families is perceived to lead to improved outcomes. For the patient and their family, it can help with reconciliation following a traumatic event and help restore their faith in the healthcare system. For the health service, listening and involving people will likely enhance learning with subsequent improvements in healthcare provision with reduction in risk of similar events occurring for other patients. This study suggests eight recommendations for involving patients and families in adverse event reviews using the APICCTHS model (table 3) which includes an apology, person-centred inclusive communication, closing the loop, timeliness, putting patients and families at the heart of the review with appropriate support for staff involved. Communicating in a compassionate manner could also decrease litigation claims following an adverse event.

Patient, carer and family experiences of seeking redress and reconciliation following a life‐changing event: Systematic review of qualitative evidence

“…Fifty‐three studies (represented by 61 articles) were eligible for inclusion in this review (see Figure 1). 18–78 …”

“…Forty‐one studies (represented by 47 articles) were prioritised for framework synthesis 18–20,22,23,25,27,29–32,34–36,38,39,42–44,47–61,63–65,68–78 . The most common countries where studies were conducted included the United States of America ( n = 12), 27,30,31,38,39,43,51,52,58,59,64,68,71,72 Australia ( n = 8) 19,22,29,34–36,41,54,61,65,69,74 and the United Kingdom ( n = 9) 18,20,25,48,55,57,76–78 .…”

“…Forty‐one studies (represented by 47 articles) were prioritised for framework synthesis 18–20,22,23,25,27,29–32,34–36,38,39,42–44,47–61,63–65,68–78 . The most common countries where studies were conducted included the United States of America ( n = 12), 27,30,31,38,39,43,51,52,58,59,64,68,71,72 Australia ( n = 8) 19,22,29,34–36,41,54,61,65,69,74 and the United Kingdom ( n = 9) 18,20,25,48,55,57,76–78 . Adverse events occurred within following fields: medical ( n = 31), 19,23,31,32,34–36,43,44,47–60,63,65,68–72,74–78 homicide ( n = 3), 27,30,38,39 sexual abuse ( n = 2), 22,29,64 employment/work‐related death ( n = 2), 42,61 death in custody ( n = 1) 25 and suicide ( n = 2) 18,20 .…”

“…The most common countries where studies were conducted included the United States of America ( n = 12), 27,30,31,38,39,43,51,52,58,59,64,68,71,72 Australia ( n = 8) 19,22,29,34–36,41,54,61,65,69,74 and the United Kingdom ( n = 9) 18,20,25,48,55,57,76–78 . Adverse events occurred within following fields: medical ( n = 31), 19,23,31,32,34–36,43,44,47–60,63,65,68–72,74–78 homicide ( n = 3), 27,30,38,39 sexual abuse ( n = 2), 22,29,64 employment/work‐related death ( n = 2), 42,61 death in custody ( n = 1) 25 and suicide ( n = 2) 18,20 . The majority of medical studies focused on the disclosure phase of the justice‐seeking process ( n = 17) 19,32,34–36,43,48,51,53,54,56–58,65,68–72,74,75 …”

Malpractice Claims and Incident Reporting: Two Faces of the Same Coin?

“…Incident reporting, therefore, is required by the most important accreditation institutions, such as the JCI. There is another reason that supports the requirement of incident reporting: only an immediate knowledge of the occurrence of an adverse event allows for non-conflictual management of the patient and their family members [ 17 ].…”