What Ibero-American hospitals do when things go wrong? A cross-sectional international study

Int J Qual Health Care. 2020 Jun 17;32(5):313-318. doi: 10.1093/intqhc/mzaa031.

Abstract

Objective: To know what hospital managers and safety leaders in Ibero-American countries are doing to respond effectively to the occurrence of adverse events (AEs) with serious consequences for patients.

Design: Cross-sectional international study.

Setting: Public and private hospitals in Ibero-American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Portugal and Spain).

Participants: A convenience sample of hospital managers and safety leaders from eight Ibero-American countries. A minimum of 25 managers/leaders from each country were surveyed.

Interventions: A selection of 37 actions for the effective management of AEs was explored. These were related to the safety culture, existence of a crisis plan, communication and transparency processes with the patients and their families, attention to second victims and institutional communication.

Main outcome measure: Degree of implementation of the actions studied.

Results: A total of 190 managers/leaders from 126 (66.3%) public hospitals and 64 (33.7%) private hospitals participated. Reporting systems, in-depth analysis of incidents and non-punitive approaches were the most implemented interventions, while patient information and care for second victims after an AE were the least frequent interventions.

Conclusions: The majority of these hospitals have not protocolized how to act after an AE. For this reason, it is urgent to develop and apply a strategic action plan to respond to this imperative safety challenge. This is the first study to identify areas of work and future research questions in Ibero-American countries.

Keywords: adverse event; hospital; open disclosure; patient safety; second victims.

MeSH terms

  • Cross-Sectional Studies
  • Family / psychology
  • Hospital Administration / methods*
  • Hospitals
  • Humans
  • Latin America
  • Medical Errors / adverse effects*
  • Medical Errors / prevention & control*
  • Patient Safety
  • Personnel, Hospital / psychology
  • Portugal
  • Safety Management
  • Spain
  • Surveys and Questionnaires