Leapfrog Group report finds areas where pediatric care must improve

Hospitals improved in some aspects of caring for pediatric patients during the COVID-19 pandemic, but there are still areas where health systems are lagging, according to a new report from the Leapfrog Group.

Reports from watchdog organizations like the Leapfrog Group have pointed to declines in patient safety in the pandemic, as hospitals and health systems have faced waves of patients and staffing shortages.

Two recent reports from the Leapfrog Group, which examined inpatient care at hospitals and outpatient surgical centers, found troubling signs of patient safety slipping. Federal officials have voiced concerns over the erosion of patient safety and urged health system leaders to make a greater commitment to protect patients and their workers.

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The Leapfrog Group’s latest report, released Thursday, focused on pediatric care. In some areas, patients reported more satisfaction with hospitals during the pandemic than before the arrival of the coronavirus.

But even in some areas where hospitals didn’t fall back, providers can do better in ensuring the safety of children, the group said.

Raising concerns

Parents gave the least favorable responses when it came to questions on preventing mistakes and helping parents or caregivers report concerns. Parents were asked if providers told them how to report concerns or mistakes, and they were also asked if staff checked to confirm the child’s identity before giving medicine.

In this area, 62% of parents and guardians gave favorable responses mid-pandemic, roughly the same as the pre-pandemic period (61.4%). The Leapfrog Group report flagged this result as “a major problem for patient safety.”

Leah Binder, president and CEO of The Leapfrog Group, said this is an area where hospitals need to do better.

“Parents or caregivers must feel comfortable raising concerns about mistakes in their children’s care at hospitals or their children are not safe,” Binder said in a statement accompanying the report. “These results raise questions about safety, which every facility that serves children should immediately address.”

The report also notes that this has been a consistent area of concern. Before the pandemic, parents gave the least favorable response on questions about reporting concerns and if hospitals were checking the identification of pediatric patients before administering medication.

“This raises serious concerns about patient safety, as giving the wrong medication can result in serious harm or even death,” the report stated.

The Leapfrog Group report also said hospitals need to view parents and guardians as “an essential part of the caregiver team.”

“A parent by their child’s bedside throughout a hospital stay may be better equipped than a medical provider to notice when something is wrong,” the report stated. “Feeling prepared to speak up immediately when they observe problems is a critical patient safety indicator, improving the odds of preventing or reducing harm from errors.”

Communication improves

Parents and caregivers gave the most favorable responses on the topic of communicating about a child’s medication. Four in five parents (80%) gave favorable responses in this topic mid-pandemic, about the same as before the pandemic (80.6%).

Doctors earned higher marks in their communication with pediatric patients during the pandemic. In this area, 76.1% of parents and caregivers gave favorable responses mid-pandemic, an uptick compared to 2019 (74%). The report noted the improvement of doctors in this area and said it’s an important step in keeping patients safe.

“Clear and understandable communication between doctors and patients can be reassuring to both parents and patients and can help prevent errors like medication mix-ups or misdiagnoses,” the report stated.

Likewise, nurses fared better in their communication skills with pediatric patients mid-pandemic. More than three-quarters (78.2%) of parents or caregivers gave favorable marks on how well nurses talked with their children mid-pandemic, up from 76.8% before the pandemic.

Hospitals generally held steady on questions about how well parents and guardians were kept informed about the care of their children. During the pandemic, 76.3% of parents gave favorable marks here, essentially the same as in 2019 (76.1%).

‘More transparency’

The Leapfrog Group called on more hospitals to share the data on surveys of parents.

Hospitals collect responses from guardians through a questionnaire known as the Consumer Assessment of Healthcare Providers and Systems Child Hospital Survey. Public reporting of the results of child patients isn’t required, but hospitals can choose to share results with organizations like The Leapfrog Group.

“The sample size for information on pediatric care remains relatively small and more transparency through reporting is needed to capture the fullest picture of the experience of pediatric patients,” the report stated.

The analysis included information from hospitals that treat pediatric patients and submitted survey results to the Leapfrog Group in 2019 and 2021.

It doesn’t include results from surveys from 2020, the first year of the pandemic, because the Leapfrog Group gave hospitals the option of re-using survey results from the previous year.