Time to listen: a review of methods to solicit patient reports of adverse events

Abstract

Background Patients have been shown to report accurate observations of medical errors and adverse events. Various methods of introducing patient reporting into patient safety systems have been published with little consensus among researchers on the most effective method. Terminology for use in patient safety reporting has yet to be standardised. Methods Two databases, PubMed and MEDLINE, were searched for literature on patient reporting of medical errors and adverse events. Comparisons were performed to identify the optimal method for eliciting patient initiated events. Results Seventeen journal publications were reviewed by patient population, type of healthcare setting, contact method, reporting method, duration, terminology and reported response rate. Conclusion Few patient reporting studies have been published, and those identified in this review covered a wide range of methods in diverse settings. Definitive comparisons and conclusions are not possible. Patient reporting has been shown to be reliable. Higher incident rates were observed when open-ended questions were used and when respondents were asked about personal experiences in hospital and primary care. Future patient reporting systems will need a balance of closed-ended questions for cause analysis and classification, and openended narratives to allow for patient's limited understanding of terminology. Establishing the method of reporting that is most efficient in collecting reliable reports and standardising terminology for patient use should be the focus of future research.

Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

“…individual interviewing of hospitalised patients or conducting follow-up by telephone on patient experiences of using health services) can be most effective in increasing the amount of patient feedback [37]. Other studies have also shown the effectiveness of actively solicited patient feedback [37,62]. …”

“…Similarly, a telephone survey in Israel revealed that, while 25% of the respondents had a cause to complain only 9.5% actually complained, and of these most complained informally [36]. However, when patients do complain their reporting of adverse events has been shown to be generally reliable [37]. We argue that health systems have a responsibility for identifying such emerging patterns [10] by analysing such data, and using these results for improving systems performance.…”

The Consequences for Incident Analysis

“…We do not yet know what other kind of events might be identifi ed as worthy of investigation by patients and families. What makes an event 'abnormal', and therefore a potential candidate for analysis, is a complex matter of surprise, rarity, intensity, severity and perhaps also the a basic feeling of the injustice of being Future reporting systems which seek to involve patients and families will need a balance of open-ended narratives and closed-ended questions for cause analysis and classifi cation (King et al 2010 ). Primary care patient reporting studies have used a combination of methods such as written, online or telephone reporting and telephone recruitment with a follow up in-person interview.…”

Is Hyperbilirubinaemia a Clinical Useful Indicator of Reduced Drug Clearance Capacity in Neonates?

“…Consumers should be involved in training of the health care workers. Two-way communication and honesty are keys to advancing understanding (2, 31, 34). …”