Identification of serious and reportable events in home care: a Delphi survey to develop consensus

Objective To assess which client events should be considered reportable and preventable in home care (HC) settings in the opinion of HC safety experts. Background Patient safety in acute care settings has been well documented; however, there are limited data about this issue in HC. While many organizations collect information about ‘incidents’, there are no standards for reporting and it is challenging to compare incident rates among organizations. Design A 29-item electronic survey that included potential HC safety issues was used in a two-round Delphi study. Setting and Participants Twenty-four pan-Canadian HC safety experts participated in an electronic survey. Main Outcome Measures Perceived reportability and preventability of patient safety events, HC. Results The events that were perceived as being most reportable and preventable included the following: a serious injury related to inappropriate client service plan (e.g. incomplete/inaccurate assessments, poor care plan design, flawed implementation); an adverse reaction requiring emergency room visit or hospitalization related to a medication-related event; a catheter-site infection (e.g. a new peritoneal dialysis infection or peritonitis); any serious event related to care or services that are contrary to current professional or other practice standards (e.g. incorrect treatment regimen, theft, retention of a foreign object in a wound, individual practicing outside scope or competence). Conclusion These data represent an important step in the development and validation of standard metrics about client safety in HC. The results address an expanding area of health services where there is a need to improve standardization and reporting.