A Multi-Site Assessment of Inpatient Safety Event Rates During the COVID-19 Pandemic.

To date, there has been a notable lack of peer-reviewed or publicly available data documenting rates of hospital quality outcomes and patient safety events during the pandemic era. The dearth of evidence is perhaps related to the US healthcare system triaging resources towards patient care and away from reporting and research, and also reflects that data used in publicly reported hospital quality rankings and ratings typically lag 2-5 years . At our institution, a learning health system assessment is underway to evaluate how patient safety was affected by the pandemic. Here, we share and discuss early findings, noting the limitations of self-reported safety event reporting, and suggest the need for further widespread investigations at other US hospitals. During the two-year study period from 2020-2021 across three large US academic medical centers at our institution, we documented an overall rate of 25.8 safety events per 1,000 inpatient days. The rate of events meeting 'harm' criteria was 12.4 per 1,000 inpatient days , the rate of non-harm events was 11.1 per 1,000 inpatient days, and the fall rate was 2.3 per 1,000 inpatient days. This descriptive, exploratory analysis suggests that patient safety event rates at our institution did not increase over the course of the pandemic. However, increasing healthcare worker absences were non-linearly and strongly associated with patient safety event rates, which raises questions regarding the mechanisms by which patient safety event rates may be affected by staff absences during pandemic peaks.