250 - Family Input for Quality and Safety (FIQS): Using Mobile Technology for In-Hospital Reporting from Families and Patients

Poster Number: 250
Publication Number: 250.1985

Background: Despite three decades of effort, ensuring inpatient safety remains elusive. Patients and family members may provide critical safety observations, but systems to gather them are limited and may exacerbate inequities if they lead to differential improvements in safety. We developed a mobile-phone based interface, co-designed with bicultural and bilingual families and unit leadership.

Objective: To gather safety observations from hospitalized patients and their family members via a real-time mobile health tool, assessing content areas and differences in reporting rates patient and caregiver characteristics.

Design/Methods: We tested the tool September 2021-August 2023 across 9 units in 3 hospitals. Participants were English or Spanish-speaking family members and patients >=12 years. We sent a daily text with a website link to the tool. We assessed associations between number of safety observations/100 study-days and patient and participant characteristics using Poisson regression.

Results: We enrolled 1317 caregivers associated with 1302 patients (Table 1) and 148 patients. All participants provided 739 safety reports (3.5 reports/100 study-days). Patient reporting rates were slightly higher than caregiver rates (3.9 vs. 3.4 /100 study-days). Reports were frequently positive, especially for patients (48% patients’ vs. 31% caregivers’ reports in “What went well” category, Figure 1). Other common topics were communication, equipment, and medications and food. In adjusted analyses, Spanish-speaking Latine/o/a, Asian, multi-racial caregivers and caregivers who chose “Other” had lower reporting rates than the overall group and lower reporting rates than White or Black non-Latine/o/a caregivers (Table 2). Reporting rates also varied by caregiver education, employment status and Ability to engage in digital services. Patients 18+ years had lower reporting rates compared to younger patients; in contrast to caregivers, reporting rates were higher for Spanish-speaking patients and for patients identifying as multi-racial (Table 2).

Conclusion(s): Patients and caregivers demonstrated substantial engagement in sharing safety observations in real-time about relevant areas of safety. Positive reporting is a popular use of the tool and may facilitate sharing constructive observations. Engaging both patients and caregivers enables a fuller assessment of safety across race, ethnicity, and language groups.