Getting the whole story: integrating patient complaints and staff reports of unsafe care
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective: It is increasingly recognized that patient safety requires heterogeneous insights from a range of stakeholders, yet incident reporting systems in health care still primarily rely on staff perspectives. This paper examines the potential of combining insights from patient complaints and staff incident reports for a more comprehensive understanding of the causes and severity of harm.
Methods: Using five years of patient complaints and staff incident reporting data at a large multi-site hospital in London (in the United Kingdom), this study conducted retrospective patient-level data linkage to identify overlapping reports. Using a combination of quantitative coding and in-depth qualitative analysis, we then compared level of harm reported, identified descriptions of adjacent events missed by the other party and examined combined narratives of mutually identified events.
Results: Incidents where complaints and incident reports overlapped (n=446, 8.5% of all complaints and 0.6% of all incident reports) represented a small but critical area of investigation, with significantly higher rates of Serious Incidents and severe harm. Linked complaints described greater harm from safety incidents in 60% of cases, reported many surrounding safety events missed by staff (n=582), and provided contesting stories of why problems occurred in 46% cases, and complementary accounts in 26% cases.
Conclusions: This study demonstrates the value of using patient complaints to supplement, test, and challenge staff reports, including to provide greater insight on the many potential factors that may give rise to unsafe care. Accordingly, we propose that a more holistic analysis of critical safety incidents can be achieved through combining heterogeneous data from different viewpoints, such as better integration of patient complaints and staff incident reporting data.
Methods: Using five years of patient complaints and staff incident reporting data at a large multi-site hospital in London (in the United Kingdom), this study conducted retrospective patient-level data linkage to identify overlapping reports. Using a combination of quantitative coding and in-depth qualitative analysis, we then compared level of harm reported, identified descriptions of adjacent events missed by the other party and examined combined narratives of mutually identified events.
Results: Incidents where complaints and incident reports overlapped (n=446, 8.5% of all complaints and 0.6% of all incident reports) represented a small but critical area of investigation, with significantly higher rates of Serious Incidents and severe harm. Linked complaints described greater harm from safety incidents in 60% of cases, reported many surrounding safety events missed by staff (n=582), and provided contesting stories of why problems occurred in 46% cases, and complementary accounts in 26% cases.
Conclusions: This study demonstrates the value of using patient complaints to supplement, test, and challenge staff reports, including to provide greater insight on the many potential factors that may give rise to unsafe care. Accordingly, we propose that a more holistic analysis of critical safety incidents can be achieved through combining heterogeneous data from different viewpoints, such as better integration of patient complaints and staff incident reporting data.
Date Issued
2022-01-01
Date Acceptance
2021-05-28
Citation
Journal of Health Services Research and Policy, 2022, 27 (1), pp.41-49
ISSN
1355-8196
Publisher
SAGE Publications
Start Page
41
End Page
49
Journal / Book Title
Journal of Health Services Research and Policy
Volume
27
Issue
1
Copyright Statement
© The Author(s) 2021. his article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
The Health Foundation
NHS North West London CCG
Grant Number
RDB04
n/a
RDF01
452981
XXKSARAVANAKUMAR
Subjects
Science & Technology
Life Sciences & Biomedicine
Health Policy & Services
Health Care Sciences & Services
patient involvement
complaints
incident reporting systems
HEALTH-CARE
SAFETY
INCIDENTS
BARRIERS
QUALITY
complaints
incident reporting systems
patient involvement
Health Policy & Services
1117 Public Health and Health Services
1402 Applied Economics
Publication Status
Published
Date Publish Online
2021-07-07