Article Text

Original research
Adverse event reviews in healthcare: what matters to patients and their family? A qualitative study exploring the perspective of patients and family
  1. Jean M McQueen1,
  2. Kyle R Gibson2,
  3. Moira Manson3,
  4. Morag Francis4
  1. 1Person Centred Care, NHS Education for Scotland West Region, Glasgow, UK
  2. 2Intensive Care, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3Assurance, Healthcare Improvement Scotland, Glasgow, UK
  4. 4Assurance, Healthcare Improvement Scotland, Edinburgh, UK
  1. Correspondence to Dr Jean M McQueen; jean.mcqueen2{at}nhs.scot

Abstract

Objectives Explore what ‘good’ patient and family involvement in healthcare adverse event reviews may involve.

Design Data was collected using semi-structured telephone interviews. Interview transcripts were analysed using an inductive thematic approach.

Setting NHS Scotland.

Participants 19 interviews were conducted with patients who had experienced an adverse event during the provision of their healthcare or their family member.

Results Four key themes were derived from these interviews: trauma, communication, learning and litigation.

Conclusions There 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.

  • Health & safety
  • Clinical governance
  • Adverse events
  • Quality in health care
  • Risk management
  • QUALITATIVE RESEARCH

Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author, JMM. The data are not publicly available due to (information that could compromise the privacy of research participants.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author, JMM. The data are not publicly available due to (information that could compromise the privacy of research participants.

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Footnotes

  • Twitter @jeanahpm

  • Contributors JMM designed the study, carried out data collection, analysed, interpreted and drafted the paper. KRG carried out data collection, analysed, interpreted and reviewed the draft manuscript. MM carried out data collection and reviewed the draft paper. MF carried out data collection. JMM, guarantor.

  • Funding The joint commission for safety, openness, and learning, where this study originated, is committed to understanding patient and family perspectives. This study is part of a larger programme of work being undertaken by NHS Education for Scotland (NES) and Healthcare Improvement Scotland (HIS) on behalf of the Scottish Government.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.