Patient reports of undesirable events during hospitalization

Abstract

Background: Thus far, incident reporting in health care has relied on health professionals. However, patients too may be able to signal the occurrence of undesirable events.

Objective: To estimate the frequency of undesirable events reported by recently discharged patients, and to identify correlates of undesirable events.

Design: Mailed patient survey.

Setting: Swiss public teaching hospital.

Participants: Adult patients (N=1,518) discharged from hospital.

Measurements: Self-reports of 27 undesirable events during hospitalization, including 9 medical complications, 9 interpersonal problems, and 9 incidents related to the health care process.

Results: Most survey respondents (1,433, 94.4%) completed the section about undesirable events, and 725 (50.6%) reported at least 1 event. The most frequent events were phlebitis (11.0%), unavailable medical record (9.5%), failure to respect confidentiality (8.4%), and hospital-acquired infection (8.2%). The odds of an unfavorable rating increased with each additional interpersonal problem (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.3 to 1.8), each additional process-related problem (OR 1.5, 95% CI 1.3 to 1.9), but not with each additional medical complication (OR 1.0, 95% CI 0.9 to 1.2). Longer duration of stay, poor health, and depressed mood were all related to a greater reported frequency of undesirable events.

Conclusion: Patients are able to report undesirable events that occur during hospital care. Such events occur in about a half of the hospitalizations, and have a negative impact on satisfaction with care.

FIGURE 1

Proportions of patients who rated health care received in hospital as poor, fair, or good (as opposed to very good or excellent) across increasing numbers of undesirable events, for interpersonal problems, process-related problems, and medical complications.