Quality and safety of hospital care from the patient perspective


Background: Delivery of high-quality, safe care is key to earning the trust and confidence of patients. Patients can be a valuable asset in determining and evaluating the quality and safety of the care they receive. Collectively analyzing patient perceptions remains a challenge.

Dr. Rani Chikkanna, division of hospital medicine, University of Kentucky, Lexington

Dr. Rani Chikkanna

Study design: Multicenter, wait-list design, cluster-randomized controlled trial.

Setting: Five National Health Service Trusts Hospital sites in the north of England.

Synopsis: Data were collected via validated survey of inpatients; 1,155 patient incident reports were gathered from 579 patients. Patient volunteers were trained to group these reports into 14 categories. Next, clinical researchers and physicians independently reviewed all reports for presence of a patient safety incident (PSI) using a previously determined consensus definition.

One in 10 patients identified a PSI. There was variability in classifying incidents as PSIs in some categories. Of the concerns expressed by patients, 65% were not classified as PSI. Limitations included a focus on patient’s concerns rather than safety, PSI estimates based on patient’s feedback without clinical information, and lack of inter-rater reliability estimates.

Bottom line: Effective translation of patient experience can provide valuable insights about safety and quality of care in hospital.

Citation: O’Hara JK et al. What can patients tell us about the quality and safety of hospital care? Findings from a UK multicentre survey study. BMJ Qual Saf. 2018 Mar 15. doi: 10.1136/bmjqs-2017-006974.

Dr. Chikkanna is an assistant professor in the division of hospital medicine at the University of Kentucky, Lexington.

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