Parents are helping prevent harm to children in hospital emergency departments, according to new research from across England and Wales.
Researchers from PRIME Centre Wales, Cardiff University, with collaborators at the University Hospital of Wales and the University College London Great Ormond Street Institute of Child Health, reviewed 4,000 patient safety incident reports involving children who attended Emergency Departments. Of the 658 incidents that involved parental participation, 90% described parents helping to prevent, identify or reduce harm to their child.
The study found that parents played a crucial role in protecting children from healthcare-related harm by:
- Raising concerns when they believed something was wrong
- Prompting reassessments and further clinical reviews
- Identifying medication issues
- Correcting inaccurate medical information
- Chasing delayed investigations, referrals or treatment
- Seeking second opinions or returning for further care when concerns remained
The findings come at a time of increasing demand on children's emergency services and growing national recognition of the importance of listening to families, including through NHS England's recent introduction of Martha's Rule - which gives patients and families the right to request an urgent review if they are concerned about a patient's condition.
The study found that parents frequently acted as an additional safety net, particularly when children were unable to communicate effectively.
Parents know their children better than anyone else. Our findings show that they are active partners in patient safety.
Chief investigator Professor Andrew Carson-Stevens, PRIME Director at Cardiff University, said: "In many cases, parents identified problems, challenged decisions, highlighted missing information and helped prevent harm before it reached their child."
The researchers revealed that many of the reports involved parents stepping in when care had been delayed or communication had broken down.
Parents frequently raised concerns about long waits for assessment, deterioration in their child's condition, missed diagnoses and failures to communicate important information between clinical teams.
In some cases, parents returned to the hospital multiple times seeking help for children whose condition had not improved, helping to identify serious illnesses that had initially been missed. Parents were found to advocate for pain relief, specialist reviews or additional investigations when they believed their child's needs were not being adequately addressed.
The research also found that 10% of reports described parents unintentionally contributing to safety incidents.
These included:
- Providing inaccurate information about medicines already given at home
- Not sharing allergy information
- Giving incorrect patient details at registration
- Misunderstanding treatment plans or medication instructions
Medication-related incidents accounted for half of all reports where parents contributed to harm.
Researchers emphasise that these incidents often occurred in emergency situations and highlight the need for healthcare systems to improve communication and support for families.
Lead author of the study, Clinical Lecturer of Patient Safety, Dr Joy McFadzean added: "Our research highlights the need for healthcare organisations to focus on creating environments where parents and families feel confident and safe to raise concerns, ask questions and challenge decisions when necessary."
Our study suggests that parents are already acting as an important safety resource within emergency care.
"As initiatives such as Martha's Rule are rolled out across the NHS, health services should ensure families are listened to, supported and recognised as valued members of the care team."
The research, Parental involvement in patient safety events in paediatric emergency care: a multi-method analysis , was published in BMJ Paediatrics Open.
