What Ibero-American hospitals do when things go wrong? a cross-sectional international study

José Joaquín Mira, Irene Carrillo, Ezequiel García-Elorrio, Daniela Campos D.E. Andrade-Lourenção, Patricia Campos Pavan-Baptista, Astolfo León Franco-Herrera, Esther Mahuina Campos-Castolo, Rodrigo Poblete, Juan Limo, Hugo Siu, Paulo Sousa

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
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OBJECTIVE: To know what hospital managers and safety leaders in Ibero-American countries are doing to respond effectively to the occurrence of adverse events (AEs) with serious consequences for patients. DESIGN: Cross-sectional international study. SETTING: Public and private hospitals in Ibero-American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Portugal and Spain). PARTICIPANTS: A convenience sample of hospital managers and safety leaders from eight Ibero-American countries. A minimum of 25 managers/leaders from each country were surveyed. INTERVENTIONS: A selection of 37 actions for the effective management of AEs was explored. These were related to the safety culture, existence of a crisis plan, communication and transparency processes with the patients and their families, attention to second victims and institutional communication. MAIN OUTCOME MEASURE: Degree of implementation of the actions studied. RESULTS: A total of 190 managers/leaders from 126 (66.3%) public hospitals and 64 (33.7%) private hospitals participated. Reporting systems, in-depth analysis of incidents and non-punitive approaches were the most implemented interventions, while patient information and care for second victims after an AE were the least frequent interventions. CONCLUSIONS: The majority of these hospitals have not protocolized how to act after an AE. For this reason, it is urgent to develop and apply a strategic action plan to respond to this imperative safety challenge. This is the first study to identify areas of work and future research questions in Ibero-American countries.

Original languageEnglish
Pages (from-to)313-318
Number of pages6
JournalInternational journal for quality in health care : journal of the International Society for Quality in Health Care
Issue number5
Publication statusPublished - 17 Jun 2020


  • adverse event
  • hospital
  • open disclosure
  • patient safety
  • second victims


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