title: Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
abstract: BACKGROUND
  Hospice provides a full range of services for patients near the end of life, often in the patient's own home. There are no published studies that describe patient safety incidents in home hospice care.
  
  
  OBJECTIVE
  The study objective was to explore the types and characteristics of patient safety incidents in home hospice care from the experiences of hospice interdisciplinary team members.
  
  
  METHODS
  The study design is qualitative and descriptive. From a convenience sample of 17 hospices in 13 states we identified 62 participants including hospice nurses, physicians, social workers, chaplains, and home health aides. We interviewed a separate sample of 19 experienced hospice leaders to assess the credibility of primary results. Semistructured telephone interviews were recorded and transcribed. Four researchers used an editing technique to identify common themes from the interviews.
  
  
  RESULTS
  Major themes suggested a definition of patient safety in home hospice that includes concern for unnecessary harm to family caregivers or unnecessary disruption of the natural dying process. The most commonly described categories of patient harm were injuries from falls and inadequate control of symptoms. The most commonly cited contributing factors were related to patients, family caregivers, or the home setting. Few participants recalled incidents or harm related to medical errors by hospice team members.
  
  
  CONCLUSIONS
  This is the first study to describe patient safety incidents from the experiences of hospice interdisciplinary team members. Compared with patient safety studies from other health care settings, participants recalled few incidents related to errors in evaluation, treatment, or communication by the hospice team.
authors.affiliation: Department of Family and Community Medicine, University of Cincinnati , Cincinatti, Ohio.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Smucker
authors.forename: Saundra
authors.initials: S
authors.lastname: Regan
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Elder
authors.forename: Erica
authors.initials: E
authors.lastname: Gerrety
mesh_terms: D000058:Accidental Falls; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006699:Home Care Services / Q000592:standards*; D017051:Hospice Care / Q000379:methods / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008508:Medication Errors; D059408:Pain Management / Q000379:methods / Q000592:standards; D010348:Patient Care Team; D061214:Patient Safety; D036301:Qualitative Research; D014481:United States