Adverse event reviews in healthcare: what matters to patients and their family? A qualitative study exploring the perspective of patients and family

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.

Keywords: Adverse events; Clinical governance; Health & safety; QUALITATIVE RESEARCH; Quality in health care; Risk management.