Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study.
OBJECTIVE
The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems.


METHODS
A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub-acute and acute medical assessment unit.


RESULTS
An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01).


CONCLUSIONS
Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under-reported in incident reporting systems, with variability in under-reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety indicators.
Monash University/Monash Health, Cheltenham, Victoria, Australia. mnsar2@student.monash.edu, mitchsarkies@gmail.com.
Mitchell N
MN
Sarkies
Monash University/Monash Health, Cheltenham, Victoria, Australia.
Kelly-Ann
KA
Bowles
Western Health and Monash University, St Albans, Victoria, Australia.
Elizabeth H
EH
Skinner
Monash University/Monash Health, Cheltenham, Victoria, Australia.
Romi
R
Haas
Monash University/Monash Health, Cheltenham, Victoria, Australia.
Deb
D
Mitchell
Monash University/Monash Health, Cheltenham, Victoria, Australia.
Lisa
L
O'Brien
Monash Health, Dandenong, Victoria, Australia.
Kerry
K
May
Western Health, St Albans, Victoria, Australia.
Marcelle
M
Ghaly
Monash University/Monash Health, Cheltenham, Victoria, Australia.
Melissa
M
Ho
Monash University/Monash Health, Cheltenham, Victoria, Australia.
Terry P
TP
Haines
D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital; D017063:Outcome Assessment, Health Care; D061214:Patient Safety; D011446:Prospective Studies; D036301:Qualitative Research; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D013997:Time Factors
clinical safety; health services research; medical informatics