Abstract
Background
Optimising transitional care by practicing family-centred care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assesses the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement programme (FIP) after major abdominal cancer surgery. Unplanned events per patient were compared between patients who received care from their family caregiver and patients who received professional at-home care after discharge.
Methods
This is a secondary analysis of the intervention group of a prospective cohort study. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analysed, and root causes were identified using the medical version of a prevention- and recovery-information system that analyses unintended events in healthcare. Statistical differences in the number of unplanned events were compared between patients who participated in the FIP and were cared for by their family caregiver after discharge and patients who participated in the FIP but received professional at-home care after discharge. A Mann-Whitney U test was used to analyse data.
Results
Of the 152 FIP participants, 68 experienced an unplanned event and were included. In total, 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics, patient conditions and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1-2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge.
Conclusion
Active family engagement in healthcare after major abdominal cancer surgery does not lead to unexpected events such as unplanned ER visits or unplanned hospital readmissions and ICU admissions. Additionally, the risk of experiencing an unplanned event does not increase when the family caregiver provides care after hospital discharge.