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The Impact of Semistructured Safety-Focused Site Visits Between Children's Hospitals.

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Bibliographic Details
Title: The Impact of Semistructured Safety-Focused Site Visits Between Children's Hospitals.
Authors: Kandil S, Vonderhaar M, Sisson P, Wood L, Brady PW, Lyren A
Source: Joint Commission journal on quality and patient safety [Jt Comm J Qual Patient Saf] 2025 Dec; Vol. 51 (12), pp. 758-766. Date of Electronic Publication: 2025 Aug 08.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101238023 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-131X (Electronic) Linking ISSN: 15537250 NLM ISO Abbreviation: Jt Comm J Qual Patient Saf Subsets: MEDLINE
Imprint Name(s): Publication: 2017- : Amsterdam : Elsevier
Original Publication: Oakbrook Terrace, IL : Joint Commission Resources, c2005-
MeSH Terms: Patient Safety*/standards , Hospitals, Pediatric*/organization & administration , Hospitals, Pediatric*/standards , Quality Improvement*/organization & administration , Safety Management*/organization & administration, Humans
Abstract: Background: Site visits are commonly used for accreditation and regulatory purposes, but little is known about how hospitals use them for safety improvement or their impact on clinical processes and outcomes.
Methods: This mixed methods study describes the key components of safety-focused site visits between hospitals and their impact on hospital safety outcomes, particularly for the visiting hospital. Hospitals were recruited via the Children's Hospitals' Solutions for Patient Safety (SPS) Network. A site visit guide was developed, covering pre-visit planning, visit execution, and post-visit debriefing. A post-visit survey and follow-up interviews (6 to 12 months later) were conducted. Themes were identified using a constant comparative approach, and statistical analysis compared rates of hospital-acquired conditions (HACs) between hospitals that participated in site visits and those that did not.
Results: From 2019 to 2021, 27 hospitals (19.6%) participated in site visits, with 14 in-person and 13 virtual. Key themes to drive a successful and useful visit highlighted the importance of peer rapport, interaction with frontline staff, structured planning, clear agendas, and thorough debriefing. Among hospitals that completed a follow-up interview, 76.5% completed at least one action item, with 56.8% of pre-determined SMART aims achieved. However, no significant difference in HAC rates, specifically central line-associated bloodstream infections (CLABSIs) and unplanned extubations (UEs), was found between site visit and non-site visit hospitals.
Conclusion: Safety-focused site visits between hospitals provide a valuable learning experience, fostering the development of improvement strategies and high rates of action item completion. However, no significant differences in safety outcomes were observed, likely due to the small sample size.
(Copyright © 2025 The Joint Commission. Published by Elsevier Inc. All rights reserved.)
Entry Date(s): Date Created: 20250913 Date Completed: 20251203 Latest Revision: 20251203
Update Code: 20251204
DOI: 10.1016/j.jcjq.2025.08.003
PMID: 40945977
Database: MEDLINE
Description
Abstract:Background: Site visits are commonly used for accreditation and regulatory purposes, but little is known about how hospitals use them for safety improvement or their impact on clinical processes and outcomes.<br />Methods: This mixed methods study describes the key components of safety-focused site visits between hospitals and their impact on hospital safety outcomes, particularly for the visiting hospital. Hospitals were recruited via the Children's Hospitals' Solutions for Patient Safety (SPS) Network. A site visit guide was developed, covering pre-visit planning, visit execution, and post-visit debriefing. A post-visit survey and follow-up interviews (6 to 12 months later) were conducted. Themes were identified using a constant comparative approach, and statistical analysis compared rates of hospital-acquired conditions (HACs) between hospitals that participated in site visits and those that did not.<br />Results: From 2019 to 2021, 27 hospitals (19.6%) participated in site visits, with 14 in-person and 13 virtual. Key themes to drive a successful and useful visit highlighted the importance of peer rapport, interaction with frontline staff, structured planning, clear agendas, and thorough debriefing. Among hospitals that completed a follow-up interview, 76.5% completed at least one action item, with 56.8% of pre-determined SMART aims achieved. However, no significant difference in HAC rates, specifically central line-associated bloodstream infections (CLABSIs) and unplanned extubations (UEs), was found between site visit and non-site visit hospitals.<br />Conclusion: Safety-focused site visits between hospitals provide a valuable learning experience, fostering the development of improvement strategies and high rates of action item completion. However, no significant differences in safety outcomes were observed, likely due to the small sample size.<br /> (Copyright © 2025 The Joint Commission. Published by Elsevier Inc. All rights reserved.)
ISSN:1938-131X
DOI:10.1016/j.jcjq.2025.08.003