WIP 128 - Safety Starts with Me: A Mixed Methods Analysis of Pediatric Trainee Safety Reporting

Poster Number: WIP 128
Publication Number: WIP 128.2571

Background: Safety work is a critical part of the evolving pediatric healthcare landscape. Event reporting and a preoccupation with failure are paramount to promoting a culture of safety. Physician trainees (e.g., residents, fellows) serve as valuable, but often underutilized, partners in organizational safety initiatives due to their experience working across departmental silos as front-line clinicians. Prior studies found trainees encounter barriers to safety reporting, largely due to their vulnerable position within hospital hierarchies. Previous work at our large, freestanding children's hospital significantly increased the use of a safety reporting tool. Little work has been performed locally or nationally to describe themes or perspectives of trainee safety reporting. A better understanding may inform system approaches to promote trainee involvement in patient and workforce safety.

Objective: Describe themes of trainee safety reporting at a freestanding children's hospital and further elicit trainee perspectives regarding safety reporting.

Design/Methods: We will perform a mixed methods study. 4213 trainee safety reports from 2017 to 2022 have been obtained. Preliminary results indicate that most reports were classified as “No Harm” (n=2301, 54%) with 33% related to medication/fluid. Next steps involve reviewing a random sample of events. A third party will de-identify data prior to analysis. A qualitative analysis of trainee submissions will be conducted to determine themes using a grounded theory approach. After establishing a shared codebook, coding will be performed by independent team members with interrater reliability calculated via Cohen’s kappa. Subsequently, trainee perspectives, informed by the previously identified themes, will be obtained via written survey and focus groups. Responses will be analyzed using descriptive statistics of Likert-scale responses and qualitative analysis of free-text responses. This project was deemed exempt by the institutional IRB.