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Structured Family-Centered Peds Rounds Improve Patient Safety

Forty percent decrease seen in harmful errors; decrease also in nonpreventable adverse events

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THURSDAY, Dec. 20, 2018 (HealthDay News) -- Structured communication involving families, nurses, and physicians can reduce harmful medical errors and improve family experience during pediatric hospitalizations, according to a study published online Dec. 5 in The BMJ.

Alisa Khan, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues conducted a multicenter before- and after-intervention study involving all patients admitted to pediatric inpatient units in seven North American hospitals. Data were included for 3,106 admissions, with 13,171 patient-days, 2,148 parents or caregivers, 435 nurses, 203 medical students, and 586 residents. Families, nurses, and physicians coproduced an intervention that included high-reliability communication emphasizing health literacy, family engagement, and bidirectional communication.

The researchers did not observe any change in the overall rate of medical errors (41.2 versus 35.8 per 1,000 patient-days for preintervention versus postintervention; P = 0.21); there was a 37.9 percent decrease in harmful errors (20.7 versus 12.9; P = 0.01). There was also a decrease in nonpreventable adverse events (12.6 versus 5.2; P = 0.003). Top box ratings improved for six of 25 components of family-reported experience, while none worsened. Family-centered rounds occurred more frequently postintervention, and improvement was noted in family engagement and nurse engagement.

"Structuring communication between health care providers and patients and families to better meets (sic) the needs of both could be an important, as yet underappreciated, means to improve the safety of patient care," the authors write.

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