Alisa Khan|Nancy D. Spector|Jennifer Baird|Michele Ashland|Amy J. Starmer|Glenn Rosenbluth|Briana M. Garcia|Katherine P. Litterer|Jayne Rogers|Anuj K. Dalal|Stuart Lipsitz|Catherine Yoon|Katherine Zigmont|Amy Guiot|Jennifer K. O’Toole|Aarti Patel|Zia Bismilla|Maitreya Coffey|Kate Langrish|Rebecca Blankenburg|Lauren Destino|Jennifer L. Everhart|Brian Good|Irene Kocolas|Rajendu Srivastava|Sharon Calaman|Sharon Cray|Nicholas Kuzma|Kheyandra D. Lewis|E. D. Thompson|Jennifer Hepps|Joseph Lopreiato|Clifton E. Yu|Helen Haskell|Elizabeth Kruvand|Dale Ann Micalizzi|Wilma Alvarado-Little|Benard P. Dreyer|H. Shonna Yin|Anupama Subramony|Shilpa J. Patel|Theodore C. Sectish|Daniel C. West|Christopher P. Landrigan
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study
Boston Children's Hospital|Harvard University|Drexel University|St. Christopher's Hospital for Children|Children's Hospital of Los Angeles|Lucile Packard Children's Hospital|Boston Children's Hospital|Harvard University|University of California, San Francisco|UCSF Benioff Children's Hospital|Boston Children's Hospital|University of California, San Francisco|Boston Children's Hospital|Boston Children's Hospital|Harvard University|National Patient Safety Foundation|Brigham and Women's Hospital|Harvard University|National Patient Safety Foundation|Brigham and Women's Hospital|National Patient Safety Foundation|Brigham and Women's Hospital|National Patient Safety Foundation|Brigham and Women's Hospital|University of Cincinnati Medical Center|Cincinnati Children's Hospital Medical Center|University of Cincinnati Medical Center|Cincinnati Children's Hospital Medical Center|University of California, San Diego|Rady Children's Hospital-San Diego|University of Toronto|Hospital for Sick Children|University of Toronto|Hospital for Sick Children|University of Toronto|Hospital for Sick Children|Stanford Medicine|Lucile Packard Children's Hospital|Stanford Medicine|Lucile Packard Children's Hospital|Stanford Medicine|Lucile Packard Children's Hospital|University of Utah|Primary Children's Hospital|University of Utah|Primary Children's Hospital|University of Utah|Primary Children's Hospital|Drexel University|St. Christopher's Hospital for Children|St. Christopher's Hospital for Children|Drexel University|St. Christopher's Hospital for Children|Drexel University|St. Christopher's Hospital for Children|Drexel University|St. Christopher's Hospital for Children|Walter Reed National Military Medical Center|Uniformed Services University of the Health Sciences|Walter Reed National Military Medical Center|Uniformed Services University of the Health Sciences|Walter Reed National Military Medical Center|Uniformed Services University of the Health Sciences|St. Louis Children's Hospital|The Task Force for Global Health|New York State Department of Health|New York University|NYU Langone Health|New York University|NYU Langone Health|Hofstra University|Cohen Children's Medical Center|University of Hawai?i at M?noa|Pacific Health Research and Education Institute|Boston Children's Hospital|Harvard University|University of California, San Francisco|UCSF Benioff Children's Hospital|Boston Children's Hospital|Harvard University|Brigham and Women's Hospital
determine whether medical errors family experience communication processes improved implementation intervention standardize structure healthcare providerfamily communication family centered roundsprospective multicenter intervention studypediatric inpatient units seven north american hospitals 17 december 2014 3 january 2017all patients admitted study units 3106 admissions 13171 patient days 2148 parents caregivers 435 nurses 203 medical students 586 residentsfamilies nurses physicians coproduced intervention standardize healthcare providerfamily communication ward rounds family centered rounds included structured high reliability communication bedside rounds emphasizing health literacy family engagement bidirectional communication structured written realtime summaries rounds formal training programme healthcare providers strategies support teamwork implementation process improvementmedical errors primary outcome including harmful errors preventable adverse events nonharmful errors modeled using poisson regression generalized estimating equations clustered site family experience communication processes eg family engagement rounds errors measured via established systematic surveillance methodology including family safety reportingthe overall rate medical errors per 1000 patient days unchanged 412 95 confidence interval 312 545 preintervention v 358 269 477 postintervention p021 harmful errors preventable adverse events decreased 379 207 153 281 v 129 89 186 p001 postintervention nonpreventable adverse events also decreased 126 89 179 v 52 31 88 p0003 top box eg excellent ratings six 25 components family reported experience improved none worsened family centered rounds occurred frequently 722 535 854 v 828 649 926 p002 family engagement 556 329 762 v 667 430 841 p004 nurse engagement 204 70 466 v 355 170 596 p003 rounds improved families expressing concerns start rounds 182 56 453 v 377 176 633 p003 reading back plans 47 07 252 v 265 127 73 p002 increased trainee teaching duration rounds change significantlyalthough overall errors unchanged harmful medical errors decreased family experience communication processes improved implementation structured communication intervention family centered rounds coproduced families nurses physicians family centered care processes may improve safety quality care without negatively impacting teaching duration roundsclinicaltrialsgov nct02320175