Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study

• Published in: Journal of evaluation in clinical practice Vol. 22; no. 5; pp. 792 - 798
• Main Authors: Sarkies, Mitchell N., Bowles, Kelly-Ann, Skinner, Elizabeth H., Haas, Romi, Mitchell, Deb, O'Brien, Lisa, May, Kerry, Ghaly, Marcelle, Ho, Melissa, Haines, Terry P.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.10.2016
• Subjects: clinical safety; Female; health services research; Humans; Interviews as Topic; Male; medical informatics; Medical Staff, Hospital; Outcome Assessment (Health Care); Patient Safety; Prospective Studies; Qualitative Research; Quality Indicators, Health Care; Quality of Health Care; Time Factors; Australia; health services research; clinical safety; medical informatics
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/jep.12543

Rationale, aims and objectives The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under‐reporting of hospital quality and safety indicators in incident reporting systems. Methods A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub‐acute and acute medical assessment unit. Results An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01). Conclusions Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under‐reported in incident reporting systems, with variability in under‐reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety indicators.