Family Input for Quality and Safety (FIQS): Using mobile technology for in-hospital reporting from families and patients
Corresponding Author
Naomi S. Bardach MD, MAS
Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
Correspondence Naomi S. Bardach, MD, MAS, Department of Pediatrics, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, San Francisco, CA 94158, USA.
Email: [email protected]; Twitter: @NaomiBardach
Search for more papers by this authorJim R. Stotts PhD, RN
Department of Patient Safety and Regulatory Affairs, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorDarren M. Fiore MD
Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorUrmimala Sarkar MD, MPH
Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
Department of Medicine, UCSF Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorAnjana E. Sharma MD, MAS
Department of Medicine, UCSF Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorW. John Boscardin PhD
Departments of Medicine and Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorLizette Avina BA
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorCaroline Peralta-Neel MPS
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorGlenn Rosenbluth MD
Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorCorresponding Author
Naomi S. Bardach MD, MAS
Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
Correspondence Naomi S. Bardach, MD, MAS, Department of Pediatrics, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, San Francisco, CA 94158, USA.
Email: [email protected]; Twitter: @NaomiBardach
Search for more papers by this authorJim R. Stotts PhD, RN
Department of Patient Safety and Regulatory Affairs, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorDarren M. Fiore MD
Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorUrmimala Sarkar MD, MPH
Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
Department of Medicine, UCSF Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorAnjana E. Sharma MD, MAS
Department of Medicine, UCSF Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorW. John Boscardin PhD
Departments of Medicine and Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorLizette Avina BA
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorCaroline Peralta-Neel MPS
Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorGlenn Rosenbluth MD
Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
Search for more papers by this authorAbstract
Objective
Despite three decades of effort, ensuring inpatient safety remains elusive. Patients and family members are a potential source of safety observations, but systems gathering these are limited. Our goal was to test a system to gather safety observations from hospitalized patients and their family members via a real-time mobile health tool.
Methods
We developed a mobile-responsive website for reporting safety observations. We piloted the tool during June 2017–April 2018 on the medical–surgical unit of a children's hospital. Participants were English-speaking family members and patients ≥13 years. We sent a daily text with a website link. We assessed: (1) face validity by comparing observations to incident reporting (IR) criteria and to hospital IRs and (2) associations between the number of safety observations/100 patient-days and participant characteristics using Poisson regression.
Results
We enrolled 235 patients (43.8% of 537 reviewed for eligibility), resulting in 8.15 safety reports/100 patient-days, most frequently regarding medications (29% of reports) and communication (20% of reports). Fifty-one (40% of 125) met IR criteria; only one (1.1%) had been reported via the IR system. Latinx participants submitted fewer observations than White participants (3.9 vs. 10.1, p = .002); participants with more prior hospitalizations submitted more observations (p < .001). In adjusted analyses, including measures of preference in decision making, and patient activation, the difference between Latinx and White participants diminished substantially (6.4 vs. 11.3, p = .16).
Conclusions
We demonstrated the feasibility of real-time patient and family-member technology-enabled safety observation reporting and elicited reports not otherwise identified. Variation in reporting may potentially exacerbate disparities in safety if not addressed.
Supporting Information
| Filename | Description |
|---|---|
| jhm2777-sup-0001-JHM_FIQS_Appendix_1_3_2021_11_18_submitted.docx960.9 KB | Supplementary information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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