Patient and Carer Participation in Reporting Patient Safety Incidents During Hospital Admission: A Scoping Review

ABSTRACT

Background

More than one in 10 patients experience harm in hospital, and patients with communication support needs are at higher risk. Patients and their carers are well‐placed to provide insights into patient safety incidents that may result in harm, which is essential to improving patient safety in hospitals.

Aim

To investigate the methods used to elicit reports of patient safety incidents from patients and their carers, the types of incident reported, and if patients with communication support needs have been included in this research to date.

Methods

A scoping review.

Results

Overall, 31 studies described a variety of methods to elicit reports of patient safety incidents from patients and carers across 12 adverse event categories. Surveys and interviews were the most common methods and elicited reports of patient safety incidents across all categories. Most research has occurred in surgical and medical wards. Few studies included patients with communication support needs, and accommodations to support their inclusion were rarely reported.

Conclusion

Patients and carers can use a variety of methods to report a wide range of patient safety incidents related to hospital care. However, vulnerable patients with communication support needs are not routinely included in the research. Future research should include these patients to better understand ways to improve hospital safety for this population.

Implications for the Profession and/or Patient Care

This study provides researchers and hospital managers with knowledge about methods used to include hospital patients and their carers in reporting patient safety incidents and identifies at‐risk patient populations currently excluded from this research.

Impact

Surveys and interviews are the most common methods to elicit reports of patient safety incidents. However, the low level of inclusion of patients with communication support needs represents a critical gap in research. Addressing this gap is essential to improving patient safety in hospitals.

Reporting Method

This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and results are reported in accordance with PRISMA‐ScR.

Patient or Public Contribution

This scoping review does not directly involve patients or the general public in its design or execution. However, this study forms a part of a wider body of research by the authors exploring in‐hospital patient safety incidents for patients with communication support needs. People with lived experience are advising on this broader program of research.

What Does This Paper Contribute to the Wider Global Clinical Community?

This review provides an up‐to‐date synthesis of international evidence relating to the reporting of hospital patient safety incidents by patients and carers. Surveys and interviews are the most widely used methods for capturing incidents across key safety domains. It highlights a persistent global gap in the inclusion of patients with communication support needs and the limited use of accommodations to support their participation. These findings inform researchers, clinicians and policy‐makers on how to strengthen patient‐reported safety systems while promoting more equitable and inclusive patient safety research and practice.

1. Introduction

Unsafe health care is a significant global issue which results in over three million deaths each year and costs approximately 13% of healthcare spending in developed countries (Slawomirski and Klazinga 2022; World Health Organisation 2024). More than one in 10 patients experience harm in hospital settings ranging from mild injury to permanent disability and death, and this rate is higher in clinical specialties such as intensive care and surgical units (Slawomirski and Klazinga 2022; World Health Organisation 2024; Panagioti et al. 2019).

Reporting of patient safety incidents is essential in improving patient safety (Connolly et al. 2024; World Health Organisation 2021). Several methods are routinely used to detect and analyse patient safety incidents from the perspective of health professionals (Connolly et al. 2024; Hibbert et al. 2023). Patients and their carers also provide valuable insights into patient safety incidents given their first‐hand experience of the entire patient journey. Despite having different definitions of patient safety incidents, patients and carers can reliably identify a wide range of incidents and provide practical suggestions on how to prevent these, which may reduce harm by up to 15% (World Health Organisation 2024; Ward and Armitage 2012; King et al. 2010; Harrison et al. 2015; Sahlström et al. 2018).

Some patient groups are particularly vulnerable to experiencing patient safety incidents including older patients and those with communication support needs (Bartlett et al. 2008; Divi et al. 2007; Hemsley et al. 2013). Patients with communication support needs include patients who have a communication disability (such as hearing loss, aphasia, or dementia) or communication difference (e.g., low literacy and/or a different cultural or language background from their healthcare provider) (Divi et al. 2007; Hemsley et al. 2013). Despite their increased risk, patients with communication support needs are often excluded from patient safety research (Hemsley et al. 2019; O'Halloran et al. 2019). However, their views and experiences of patient safety incidents are crucial to understanding the reasons for this increased risk and any potential mitigating strategies.

2. The Review

Previous reviews of the literature have shown that the most common methods for patients and carers to report patient safety incidents are surveys and interviews, with wide variations in the timing between the patient safety incident and reporting (Ward and Armitage 2012; King et al. 2010; Harrison et al. 2015; Kinnunen and Sarantob 2013). However, the most recent review was published 10 years ago (Harrison et al. 2015). An updated review of the literature is required to: (a) map the current evidence for eliciting reports of patient safety incidents from patients and their carers and (b) determine whether patients with communication support needs and their carers are included in the research. The specific research questions addressed by this review are as follows:

1. What methods are currently used to elicit reports of patient safety incidents from patients and carers about hospital admissions?

2. Do different types of methods of reporting reveal different types of incidents?

3. Have patients with communication support needs been included in patient or carer reported safety research to date?

3. Method

3.1. Design

This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews (Peters et al. 2022). The protocol was registered on Open Science Framework (Sullivan and O'Halloran 2024), with two deviations. Firstly, the inclusion criteria were refined during full text review to ensure that only studies that included an aim related to the reporting of patient safety incidents by patients or carers were included. Secondly, the third aim of the review in the protocol “have some groups of patients or care types been excluded from patient reported safety research to date?” was refined to specifically focus on the inclusion of patients with communication support needs.

3.2. Inclusion and/or Exclusion Criteria

To be included in the review, papers needed to be original studies in any language that described patient safety incidents in an inpatient hospital setting, reported by adult patients or their carers (Table 1).

TABLE 1.

Inclusion and exclusion criteria.

Category	Inclusion criterion	Exclusion criterion
Population	Adults (aged 18 years or older) or studies where adults are included in the data and reported separately. AND Inpatients receiving any type of care or studies where inpatient data is reported separately.	Infants/children (under 18).
Concept	Studies that describe patient safety incidents reported by patients or carers. The aim of the study directly includes the reporting of patient safety incidents by patients or carers.	Studies that only report on other methods of detecting or reporting patient safety incidents that do not include patient or carer reports.
Context	Inpatient wards in hospitals.	Patients not admitted to hospital. Patients in Emergency Departments.
Source	Original, peer reviewed papers of any study design.	Reviews (e.g., systematic reviews, scoping reviews), position statements, editorials, commentaries, conference proceedings, letters to the editor, expert opinion and secondary sources, studies that cannot be translated into English using professional translation services.

3.3. Search Methods

The search strategy was determined in consultation with a health science librarian from La Trobe University and included key word and subject headings relating to the concepts of ‘patient safety’, ‘patient reports or voluntary reports’ and ‘inpatient or hospital’. To ensure the search remained within the available resources, the search term ‘adverse events’ was not included as it was shown to produce many studies involving pharmaceutical drug trials (Tchijevitch et al. 2025). Instead, we utilized terms relating to ‘hospital acquired complication’ and ‘patient safety incident’ that were relevant to each database.

In June 2024 and July 2025, five databases (Medline, PsycINFO, CINAHL, Embase and Web of Science) were systematically searched (see supplemental material). In addition, the AI‐enabled Dimensions database, the National Patient Safety Foundation Bibliography and the Agency for Healthcare Research and Quality, Patient Safety Net Bibliography, were searched using a title and abstract keyword search. Reference lists from seven relevant publications from the Institute for Healthcare Improvement were hand searched. To address the novel research question ‘have patients with communication support needs been excluded from patient or carer reported safety research to date?’ no date limits were applied to any search. All studies included in the four previous systematic reviews published in this field were included in the title and abstract screening process (Ward and Armitage 2012; King et al. 2010; Harrison et al. 2015; Kinnunen and Sarantob 2013). Other literature reviews identified in the search (Millman et al. 2011; Murff et al. 2003; Guijarro et al. 2010; Schwappach 2010) and the reference lists from studies included in this review were hand searched.

3.4. Search Outcome

The search results were exported into Covidence and duplicates removed. Title and abstracts were screened against the inclusion criteria by two reviewers (RS, TR and SEL) and discrepancies resolved by a third reviewer (ROH). Where titles were published in languages other than English, the English abstract provided by the publisher was screened. Where studies potentially met the criteria for inclusion, or if the eligibility was unable to be determined, full texts were retrieved. The inclusion and exclusion criteria were applied to full text studies by two reviewers (RS, TR, SEL) and disagreement resolved by a third reviewer (ROH). Full text articles published in languages other than English were translated by a professional translator (Walpole 2019) and then screened for eligibility by two English speaking authors (RS and ROH). Where two or more studies used the same data set, only one study was included based on the most relevant aim and results.

3.5. Data Abstraction and Synthesis

Data from included studies was extracted into a bespoke Microsoft Excel spreadsheet enabling analysis across studies. The data extraction template was piloted by the first author on the first three included studies, then refined to capture further relevant information. Data were extracted on the Excel spreadsheet by the first author and independently reviewed and cross checked for accuracy by the final author with 98% agreement on extraction accuracy. Extracted data included (i) citation details; (ii) country of study; (iii) study design; (iv) aims and purpose of the study; (v) study population, including eligibility criteria, type of communication support need if applicable, and documentation of communication supports or adaptations to support the participation of people with communication support need; (vi) sample size and demographics of participants; (vii) method used for eliciting reports of patient safety incidents from participants, including any tools used; (viii) timing of data collection in relation to the incident; (ix) type of incident reported, including any framework used to classify the event; (x) key findings; and (xi) reported strengths and limitations. To facilitate analysis, patient safety incidents were grouped into 12 categories based on the World Health Organization Global Patient Safety Report 2024 (World Health Organisation 2024), these being: (i) medication errors; (ii) diagnostic errors; (iii) infections; (iv) blood and blood products; (v) falls; (vi) pressure ulcers; (vii) patient identification error; (viii) surgical complications; (ix) medical complications; (x) test or equipment complications; (xi) nutrition; and (xii) other. Patient safety incidents were categorized based on how they were reported in the studies. Where studies reported patient safety incidents in more than one category, each incident was included and counted in all relevant categories.

3.6. Quality Appraisal

In keeping with recommendations for scoping reviews, a quality assessment was not conducted (Peters et al. 2022). Data were analysed descriptively, and results are reported in accordance with PRISMA‐ScR (Tricco et al. 2018).

4. Results

4.1. Selection of Sources of Evidence

As detailed in Figure 1, the initial database search yielded 5115 studies, with 1205 duplicates. The updated search yielded an additional 748 studies, with 209 duplicates. All titles published in a language other than English had an English abstract provided by the publisher for screening. In total, 136 full text studies were retrieved, of which one was published in Spanish and two in Portuguese. These were translated and eligibility reviewed as per the method described. These 136 studies were screened against the inclusion criteria, yielding 24 studies for inclusion. Of these, 1 study was identified in the updated search, published in the 12 months since the initial search. Following forward and backward citations, an additional 100 studies were retrieved and screened against the inclusion criteria, yielding a further 7 studies for inclusion. Overall, 31 studies were included in the review, all of which were published in English. Nine of these studies were included in the previous systematic reviews.

FIGURE 1.

PRISMA Flow Diagram.

4.2. Characteristics of Sources of Evidence

Of the included studies, 20 were quantitative (Agoritsas et al. 2005; Eden et al. 2017; Fernando et al. 2021; Fowler et al. 2008; Giardina et al. 2020; Hasegawa et al. 2011; Hill et al. 2010; Kaboli et al. 2010; Kalisch et al. 2014; Laukkavirta et al. 2020; Levtzion‐Korach et al. 2010; Marsall et al. 2024; O'Hara et al. 2018; Reader and Gillespie 2021; Schmidt 2004; Sutton 1994; Wan et al. 2023; Yan et al. 2017; Schmid et al. 2009; Sarpong et al. 2025), 10 mixed methods (Armitage et al. 2018; Collins et al. 2020; Davis et al. 2013; O'Hara et al. 2017; Schnock et al. 2022; Schwappach 2008; Van Melle et al. 2016; Walton et al. 2017; Weingart et al. 2005; Weissman et al. 2008) and one qualitative in design (Haldar et al. 2020) (Table 2). The majority of the studies were conducted in the United States of America (Eden et al. 2017; Fowler et al. 2008; Giardina et al. 2020; Kaboli et al. 2010; Kalisch et al. 2014; Levtzion‐Korach et al. 2010; Reader and Gillespie 2021; Schmidt 2004; Schmid et al. 2009; Sarpong et al. 2025; Collins et al. 2020; Schnock et al. 2022; Weingart et al. 2005; Weissman et al. 2008; Haldar et al. 2020), five in England (O'Hara et al. 2018, 2017; Sutton 1994; Armitage et al. 2018; Davis et al. 2013), two each in Australia (Hill et al. 2010; Walton et al. 2017), China (Wan et al. 2023; Yan et al. 2017) and Switzerland (Agoritsas et al. 2005; Schwappach 2008) and one in Japan (Hasegawa et al. 2011), Germany (Marsall et al. 2024), Canada (Fernando et al. 2021), Finland (Laukkavirta et al. 2020) and the Netherlands (Van Melle et al. 2016). Eighteen of the studies were published in the last 10 years (Eden et al. 2017; Fernando et al. 2021; Giardina et al. 2020; Kalisch et al. 2014; Laukkavirta et al. 2020; Marsall et al. 2024; O'Hara et al. 2018, 2017; Reader and Gillespie 2021; Wan et al. 2023; Yan et al. 2017; Sarpong et al. 2025; Armitage et al. 2018; Collins et al. 2020; Schnock et al. 2022; Van Melle et al. 2016; Walton et al. 2017; Haldar et al. 2020). In the 28 studies that reported the sample size of participants, the range was 13 participants (Van Melle et al. 2016) to 7372 participants (Walton et al. 2017). Eighteen studies reported the age of participants, the average being 59.4 years (Agoritsas et al. 2005; Eden et al. 2017; Fernando et al. 2021; Hasegawa et al. 2011; Hill et al. 2010; Kaboli et al. 2010; Kalisch et al. 2014; Laukkavirta et al. 2020; Marsall et al. 2024; O'Hara et al. 2018, 2017; Schmidt 2004; Wan et al. 2023; Schmid et al. 2009; Sarpong et al. 2025; Davis et al. 2013; Schwappach 2008; Van Melle et al. 2016; Weingart et al. 2005). Six studies reported age in range categories (Fowler et al. 2008; Yan et al. 2017; Schnock et al. 2022; Walton et al. 2017; Weissman et al. 2008; Haldar et al. 2020), of these, one reported the most prevalent age range between 18 and 44 years (Yan et al. 2017), two between 45 and 64 years (Schnock et al. 2022; Haldar et al. 2020) and the remaining three 60 years and over (Fowler et al. 2008; Walton et al. 2017; Weissman et al. 2008). Further, one study reported age by gender (Sutton 1994) and another by type of patient safety incident (Giardina et al. 2020). The remaining four studies did not report age (Levtzion‐Korach et al. 2010; Reader and Gillespie 2021; Armitage et al. 2018; Collins et al. 2020). In studies reporting gender (n = 23), the average proportion of males was 48.5% (Agoritsas et al. 2005; Eden et al. 2017; Fernando et al. 2021; Fowler et al. 2008; Giardina et al. 2020; Hasegawa et al. 2011; Hill et al. 2010; Kaboli et al. 2010; Kalisch et al. 2014; Laukkavirta et al. 2020; Marsall et al. 2024; O'Hara et al. 2018; Schmidt 2004; Wan et al. 2023; Yan et al. 2017; Sarpong et al. 2025; Davis et al. 2013; Schnock et al. 2022; Schwappach 2008; Van Melle et al. 2016; Walton et al. 2017; Weingart et al. 2005; Weissman et al. 2008; Haldar et al. 2020).

TABLE 2.

Summary of extracted data.

First author, year of publication	Country of study	Study design	Study aim	Number of participants (N)	Age (years)	Gender (%, male)
Agoritsas et al. (2005)	Switzerland	Quant	(1) Patient reports of frequency of undesirable events (2) Identify the patient and hospital stay characteristics that are associated with undesirable events (3) Examine the association between occurrence of incidents and the global assessment of the hospital stay	1433	56 (mean) SD:19.3 Range:19–98	44.4
Armitage et al. (2018)	England	Mixed methods	(1) Develop and implement a co‐produced reporting tool for hospitalized patients to provide feedback on their safety concerns (2) Compare data on safety concerns of patients and experiences captured by a patient incident reporting tool with data collected retrospectively through case note review, staff incident reports and the Patient Advice and Liaison Service (3) To quantify any overlap between these various sources of data (4) discuss the implications for patient involvement and the management of safety	321 adult patients	Not reported	Not reported
Collins et al. (2020)	USA	Mixed methods	(1) Evaluate patient/care partner safety reporting submission trends using MySafeCare (2) Explore patient/care partner perspectives on safety concerns while in hospital	MySafeCare n = 32 15 interviews (11 patient only, 2 care partner only, 2 patient and care partner)	Optional on app Not reported in interviews	Not reported
Davis et al. (2013)	England	Mixed methods	Patients' willingness and ability to provide information about medical errors or undesirable events they experienced in hospital	80	58 (mean) SD: 16.6 Range 19–88	70
Eden et al. (2017)	USA	Quant	(1) Describe the characteristics of patients for whom Condition Help was activated at hospital (2) Describe reasons for calls, changes in care and outcomes	240	45.8 (mean)	38
Fernando et al. (2021)	Canada	Quant	Does routine reporting by patients or physicians improve identification of hospital acquired complications	207	63 (median) IQR: 52–72	60
Fowler et al. (2008)	USA	Quant	(1) Estimate the rates at which patients experience what they considered to be adverse events (2) Describe the kids of events they reported (3) Identify the correlates of those reports	2582	18–49 n = 646 50–64 n = 722 65–74 n = 568 75+ n = 646	42
Giardina et al. (2020)	USA	Quant	To determine the association between patient‐reported contributory factors and patient‐reported harm	351	Non‐physical harm: 51.3 (mean) Physical Harm only: 53.4 (mean) Physical Harm & Emotional OR Financial Harm: 49.8 (mean) Physical, Emotional and Financial harm: 48.6 (mean)	Non‐physical harm: 22.4% Physical Harm only: 38.3% Physical Harm & Emotional OR Financial Harm: 27.8 Physical, Emotional and Financial harm: 22.4
Haldar et al. (2020)	USA	Qual	To understand how inpatients experience undesirable events and to surface opportunities for those informatics solutions	242	19–24 n = 2 25–44 n = 17 45–64 n = 45 65+ n = 36	18.7
Hasegawa et al. (2011)	Japan	Quant	To compare the patients and health care staff's identification and reporting of adverse events	1738	59.4 (mean)	48.6
Hill et al. (2010)	Australia	Quant	(1) To compare three independent methods of falls reporting (incident reports, participant reports, medical records) (2) To examine whether reporting of falls through hospital reporting system is related to participant or spatiotemporal factors related to the fall	153	75.1 (mean) SD:11.0	46.8
Kaboli et al. (2010)	USA	Quant	To determine whether an optimal system exists for identifying and reporting medication misadventures as experience at the patient bedside to supplement the reporting already completed by pharmacists	126	54 (mean)	54
Kalisch et al. (2014)	USA	Quant	(1) What is the extent and type of missed nursing care identified by hospitalized patients? (2) Do the amounts and types of patient reported missed nursing care vary by hospital? (3) Are patient‐reported outcomes (i.e., fall, skin breakdown/pressure ulcer, medication error, hospital‐acquired infection) associated with missed nursing care? (4) What patient demographic and health status variables influence patient perceptions of missed nursing care?	729	59.76 (mean) SD:16.42	51.1
Laukkavirta et al. (2020)	Finland	Quant	Identify specific incidents that led to patient injuries in the treatment of patients with PAD in Finland over a 14‐year period to help prevent such incidents in future	625	67.0 (mean) SD:8.7 Range: 47–86	61.7
Levtzion‐Korach et al. (2010)	USA	Quant	(1) To evaluate what type of information is received by each system (2) Develop a common framework for representing the identified safety issues (3) assess the correlation between types of information collected by the different systems (4) Evaluate the overall safety picture	4722	Not reported	Not reported
Marsall et al. (2024)	Germany	Quant	To investigate the associations between the quality and safety of the discharge process, patient safety incidents and health‐related outcomes after discharge, considering the treatments' and patients' contextual factors in one comprehensive model.	786	60.8 (mean) SD:18 Range:19–94	50.9
O'Hara et al. (2018)	England	Quant	(1) What concerns about safety do hospital patients report? (2) How do patients make sense of and categorize these safety concerns? (3) what is the incidence and nature of PSIs experienced by this sample of patients	2471	60 (mean) SD: 18.3 Range: 16–103	52.2
O'Hara et al. (2017)	England	Mixed Methods	(1) Can patients relay their safety concerns using a variety of different mechanisms for capturing such data? (2) Which mechanism might be the most successful in collecting patient‐reported safety concerns? (3) Are there differences in the types of patient‐reported safety concerns captured by different mechanisms, in terms of physician rated classification as a PSI, or the associated degree of preventability or severity?	178	58.14 (mean) SD: 16.24	Not reported
Reader and Gillespie (2021)	USA	Quant	(1) Are patient‐generated data on unsafe hospital care, captured through patient evaluations of care and health care complaints, associated with hospital level mortality (2) Do patient‐generated data on unsafe hospital care, captured through patient evaluations of care and healthcare complaints, explain additional variance in hospital‐level mortality beyond that of staff evaluations of care and incident reports?	2017	Not reported	Not reported
Sarpong et al. (2025)	USA	Quant	(1) What is the prevalence of the types of missed nursing care reported by patients in Western Australian acute care settings (2) What is the prevalence of patient‐reported adverse events (such as fall, skin breakdown/pressure ulcer, medication error and hospital acquired infection) in Western Australian acute care settings (3) what are the demographic and health status factors associated with patient‐reported missed nursing care	98	59.04 (mean) Range 18–87	42.90
Schmid et al. (2009)	USA	Quant	(1) To determine the proportion of those with fear of falling immediately after stroke (2) compare stroke‐specific health‐related quality of life, occupational performance and psychological and cognitive symptoms between persons with and without fear of falling	28	59.04 (mean) SD:10.04	Not reported
Schmidt (2004)	USA	Quant	(1) Are there significant differences on patient perceptions of nurse staffing, their perception of nursing care and their overall satisfaction with the hospital experience based on whether they experience one or more adverse events while hospitalized (2) What is the incidence of patients' self‐reported adverse events (3) Where do patients' self‐report of adverse events fit into the conceptual system of patients' perceptions of nurse staffing, the nursing care they receive and their overall satisfaction with the hospital experience?	148	57.35 (mean) SD:15.74	45.8
Schnock et al. (2022)	USA	Mixed Methods	(1) Evaluate the rate of patients' safety concerns submitted by MySafeCare (2) Explored patient perspectives on safety during hospitalization	46	< 25 n = 3 24–44 n = 3 45–64 n = 15 > 65 n = 5 Unknown n = 20	13 Unknown: 45.7
Schwappach (2008)	Switzerland	Mixed Methods	(1) Develop and pilot a brief patient safety survey	125	55 (mean) SD:18 Range: 17–91	37.5
Sutton (1994)	England	Quant	To investigate the incidence of unreported accidents and compare this with incidence of reported patient accidents in the study wards	574	Male = 66.6 Female = 69.3	Not reported
Van Melle et al. (2016)	Netherlands	Mixed methods	To investigate whether transitional incidents can be identified from the medical records of the GP and hospital and assess the concordance between these medical records and the patient interviews.	13	59 (mean)	46
Walton et al. (2017)	Australia	Mixed methods	To investigate the experiences of patients in New South Wales hospitals who suffered an adverse event	7372	50–59 n = 1231 60–69 n = 2308 70–79 n = 2156 80–110 n = 1669	52.8
Wan et al. (2023)	China	Quant	To investigate PICC related complications in 4 Chinese hospitals	3285	59 (mean) SD: 18	41.4
Weingart et al. (2005)	USA	Mixed methods	(1) To determine whether inpatients and their families could identify adverse events and near misses (2) Characterize patients' reports, to analyse the factors associated with error and injury reporting (3) to compare patient reporting to the usual incident reporting system	228	63.0 (mean) SD: 18.3 Range: 19–102	37.3
Weissman et al. (2008)	USA	Mixed methods	To compare adverse events reported in post discharge patient interviews with adverse events detected by medical record review	998	18–44 n = 123 45–59 n = 341 > 60 n = 534	47.4
Yan et al. (2017)	China	Quant	(1) To identify the frequency of undesirable events reported by patients during hospitalization (2) Explore the relationship between undesirable events and perception of safety and satisfaction with care in China.	341	18–44 n = 155 45–59 n = 117 60–87 n = 69	51.6

Abbreviations: IQR, interquartile range; Quant, Qualitative; Qual, qualitative; SD, standard deviation.

Of the studies included, 25 specifically reported the clinical specialty from which data were collected (see Table 3). There were 30 clinical specialties in total, the most common of which were surgical and medical wards. Other clinical specialties included oncology, gynecology‐obstetrics, internal medicine, acute care and vascular surgery. The remaining seven studies did not report a specific clinical specialty (Giardina et al. 2020; Hasegawa et al. 2011; Levtzion‐Korach et al. 2010; Marsall et al. 2024; Reader and Gillespie 2021; Wan et al. 2023; Walton et al. 2017).

TABLE 3.

Clinical specialties included in each study.

First author	Surgery	Vascular surgery	Urological surgery	General surgery	General medical	Acute care	Medical intensive care	Geriatrics	Geriatric assessment and rehabilitation	Health care of the elderly
Agoritsas et al. (2005)	X				X			X
Armitage et al. (2018)	X				X
Collins et al. (2020)							X
Davis et al. (2013)	X				X
Eden et al. (2017)	X				X
Fernando et al. (2021)
Fowler et al. (2008)	X				X
Haldar et al. (2020)	X				X
Hill et al. (2010)					X				X
Kaboli et al. (2010)						X
Kalisch et al. (2014)	X				X
Laukkavirta et al. (2020)		X
O'Hara et al. (2018)	X				X
O'Hara et al. (2017)		X	X	X
Sarpong et al. (2025)	X		X	X	X			X
Schmid et al. (2009)						X
Schmidt (2004)	X
Schnock et al. (2022)				X
Schwappach (2008)	X
Sutton (1994)	X				X				X
Van Melle et al. (2016)
Weingart et al. (2005)	X				X
Weissman et al. (2008)	X				X
Yan et al. (2017)	X				X

First author	Psychogeriatric medicine	Acute care geriatric program	Genecology	Obstetrics	Maternity	Orthopaedic unit	Orthopaedic and trauma	Oncology	Psychiatry	Neurosciences	Dermatology
Agoritsas et al. (2005)			X	X					X	X	X
Armitage et al. (2018)					X
Collins et al. (2020)								X
Davis et al. (2013)
Eden et al. (2017)
Fernando et al. (2021)
Fowler et al. (2008)
Haldar et al. (2020)
Hill et al. (2010)						X
Kaboli et al. (2010)
Kalisch et al. (2014)
Laukkavirta et al. (2020)
O'Hara et al. (2018)
O'Hara et al. (2017)
Sarpong et al. (2025)						X		X
Schmid et al. (2009)
Schmidt (2004)
Schnock et al. (2022)
Schwappach (2008)
Sutton (1994)	X						X
Van Melle et al. (2016)
Weingart et al. (2005)		X	X	X				X
Weissman et al. (2008)
Yan et al. (2017)

First author	Renal	Gastroenterology	Rheumatology	Respiratory medicine	Diabetes/Endocrinology	Cardiology	Neurology/Neurosurgery	Rehabilitation Unit	Internal Medicine	Vascular	Ophthalmology
Agoritsas et al. (2005)
Armitage et al. (2018)
Collins et al. (2020)										X
Davis et al. (2013)
Eden et al. (2017)
Fernando et al. (2021)									X
Fowler et al. (2008)
Haldar et al. (2020)
Hill et al. (2010)
Kaboli et al. (2010)
Kalisch et al. (2014)								X
Laukkavirta et al. (2020)
O'Hara et al. (2018)
O'Hara et al. (2017)	X	X	X	X	X	X
Sarpong et al. (2025)		X	X		X	X	X				X
Schmid et al. (2009)
Schmidt (2004)
Schnock et al. (2022)									X
Schwappach (2008)									X
Sutton (1994)							X				X
Van Melle et al. (2016)		X					X		X
Weingart et al. (2005)
Weissman et al. (2008)
Yan et al. (2017)

4.3. Methods Currently Used to Elicit Reports of Patient Safety Incidents From Patients and Carers During Hospital Admission

Surveys were the most common type of method used to elicit reports of patient safety incidents from patients and carers during hospital admission (Agoritsas et al. 2005; Fernando et al. 2021; Fowler et al. 2008; Giardina et al. 2020; Hasegawa et al. 2011; Kalisch et al. 2014; Marsall et al. 2024; O'Hara et al. 2018; Schmidt 2004; Yan et al. 2017; Sarpong et al. 2025; Armitage et al. 2018; Davis et al. 2013; Walton et al. 2017; Haldar et al. 2020), followed by interviews (Hill et al. 2010; Kaboli et al. 2010; Sutton 1994; Schmid et al. 2009; Van Melle et al. 2016; Weissman et al. 2008). Other methods of eliciting reports of patient safety incidents from patients or carers were insurance injury claims (n = 1) (Laukkavirta et al. 2020), patient complaints (n = 2) (Levtzion‐Korach et al. 2010; Reader and Gillespie 2021), web‐based apps available during hospitalization (n = 2) (Collins et al. 2020; Schnock et al. 2022) and a telephone hotline available during admission (n = 1) (Eden et al. 2017). Four studies used more than one method to elicit reports of patient safety incidents from patients and carers (Wan et al. 2023; O'Hara et al. 2017; Schwappach 2008; Weingart et al. 2005).

There was little commonality in the timing of data collection periods across the 25 studies that reported when they collected data (Agoritsas et al. 2005; Eden et al. 2017; Fernando et al. 2021; Fowler et al. 2008; Hasegawa et al. 2011; Hill et al. 2010; Kaboli et al. 2010; Kalisch et al. 2014; O'Hara et al. 2018, 2017; Sutton 1994; Wan et al. 2023; Yan et al. 2017; Schmid et al. 2009; Sarpong et al. 2025; Armitage et al. 2018; Collins et al. 2020; Davis et al. 2013; Schwappach 2008; Van Melle et al. 2016; Walton et al. 2017; Weingart et al. 2005; Weissman et al. 2008; Haldar et al. 2020). Immediate reporting of patient safety incidents was described in two studies (Eden et al. 2017; Collins et al. 2020). During admission, the time to report patient safety incidents varied and included any time from 4 h on a ward (O'Hara et al. 2018), daily interviews (Hill et al. 2010) to the day before or day of discharge (Fernando et al. 2021; Yan et al. 2017). In the Haldar et al., (Haldar et al. 2020) survey, patients and carers could describe any patient safety incident experienced during any hospital admission, at any hospital site. Where studies were seeking reports after patients were discharged, the time varied from 5 days (Davis et al. 2013), 6 months (Schmid et al. 2009), 9 months (Hasegawa et al. 2011; Sarpong et al. 2025; Armitage et al. 2018) to 12 months in Weissman et al., (Weissman et al. 2008).

4.4. Do Different Types of Methods of Reporting Reveal Different Types of Patient Safety Incident in Care?

The 31 included studies captured an extensive list of patient safety incidents. Within each of the 12 categories listed in the World Health Organization Global Patient Safety Report, the included studies reported multiple types of patient safety incidents, which are outlined in Table 4 and further detailed in Table 5. Details on the types of methods used to reveal different types of patient safety incidents were included in 23 of the 31 studies (see Table 5) (Agoritsas et al. 2005; Fernando et al. 2021; Fowler et al. 2008; Giardina et al. 2020; Hasegawa et al. 2011; Kalisch et al. 2014; Levtzion‐Korach et al. 2010; O'Hara et al. 2018; Reader and Gillespie 2021; Schmidt 2004; Sutton 1994; Yan et al. 2017; Sarpong et al. 2025; Armitage et al. 2018; Collins et al. 2020; Davis et al. 2013; O'Hara et al. 2017; Schnock et al. 2022; Schwappach 2008; Walton et al. 2017; Weingart et al. 2005; Weissman et al. 2008; Haldar et al. 2020). Where a single method was used to elicit reports of patient safety incidents from patients or their carers, surveys captured reports across all 12 categories (Agoritsas et al. 2005; Fernando et al. 2021; Fowler et al. 2008; Giardina et al. 2020; Hasegawa et al. 2011; Kalisch et al. 2014; O'Hara et al. 2018; Schmidt 2004; Yan et al. 2017; Sarpong et al. 2025; Armitage et al. 2018; Davis et al. 2013; Walton et al. 2017; Haldar et al. 2020). When interviews were used, patients and carers reported patient safety incidents in seven categories (Sutton 1994; Weissman et al. 2008). Web‐based applications captured incidents across four of the 12 categories (Collins et al. 2020; Schnock et al. 2022) and patient complaints captured incidents in three categories (Levtzion‐Korach et al. 2010; Reader and Gillespie 2021). In studies that used more than one method to elicit reports of patient safety incidents from patients or carers (O'Hara et al. 2017; Schwappach 2008; Weingart et al. 2005), incidents were captured in eight of the 12 categories; (i) medication errors, (ii) infections, (iii) blood and blood products, (iv) falls, (v) patient identification errors, (vi) surgical complications, (vii) test or equipment complications and (viii) other.

TABLE 4.

Type of patient safety incidents identified by method of eliciting reports of patient safety incident.

Category	Methods used to capture event	Specific patient safety incident described in the included studies
Medication Errors	Survey Interview Phone Line Web‐based application Patient Complaint Insurance Chart reviews	Allergic reaction to medication Prescribed a medication with known allergy Side effects from medication Incorrect medication Medication given at the wrong time, wrong dose, missed dose Overdose or extra dose Failed to order medication Inappropriate choice of medication Incorrect method of medication administration Failure to recognize contraindication to medication Inadequate monitoring or failure to observe therapy
Diagnostic Errors	Survey Interview Patient Complaint	Incorrect diagnosis Delayed diagnosis Missed diagnosis
Infection	Survey Interview Web‐based application	Hospital acquired infection Inadequate clinical protocols with risk of infection Pneumonia Urinary tract infection (with or without catheter) Post surgical infection Wound infection Central line associated blood stream infection Hospital acquired bacteraemia
Blood and blood products	Survey Interview	Phlebitis Bleeding after an operation or catheterization Poor tolerance of a blood transfusion Blood clot in legs or lungs Uncontrolled bleeding Blood transfusion Post surgical haemorrhage Deep vein thrombosis Pulmonary embolism
Falls	Survey Interview Web‐based application	Injuries in a fall Fall
Pressure Ulcers	Survey Web‐based application Interview	Developed a pressure ulcer Unmet care needs with risk of pressure ulcer sores
Patient Identification Error	Survey Interview	Medication administered to the wrong patient Test or procedure performed on the wrong patient
Surgical Complications	Survey Insurance Chart review Interview	Reoperated on urgently within 3 days of initial operation Anaesthesia Nerve, organ, or vessel injuries Skin burns Post operative acute myocardial infarction, stroke, shock or respiratory distress Technical errors such as graft kinking Retained foreign material Surgery was or nearly was performed on the wrong body site
Medical Complications (including sepsis, unsafe transfusion and injection practices)	Survey Interview	Transferred to intensive care due to a complication Unplanned readmission Developed a sore arm or inflammation because of a drip Delirium Kidney injury Heart attack Stroke Sudden drop in blood pressure Rash Difficulty breathing/respiratory arrest Nerve damage Shock Cardiac arrest Upper gastrointestinal bleeding Sepsis Central nervous system complications Skin tears Pneumothorax Unplanned extubation
Test OR Equipment Complications	Survey Interview	A test was not done when it should have been, repeated needlessly, cancelled, or delayed Error in test result Medical device Drain and Tube Laboratory test Medical record or radiographs were not available when needed A test was nearly or was performed on the wrong site of the body Equipment malfunction
Nutrition	Survey	Food/drink provided that was not allowed on diet Inadequate diet or nutrition Nutrition Not providing food/water
Other	Survey Interview Web‐based application Phone call Patient complaint	Consent was not obtained before a test or an intervention Poor care planning Delays/Waiting time Medical records were unavailable when needed Uncontrolled pain IV running dry, or leaking into skin Acute psychiatric issues Treatment protocol Breakdowns between providers Errors in providing clinical treatment Mistakes by unqualified staff Intervention Physicians' examination

TABLE 5.

List of patient safety incidents in each category from the included studies, and the method used to elicit reports of these incidents.

	Method	Medication errors	Diagnostic errors	Infection	Blood	Fall	Pressure ulcers	Patient identification error	Surgical complications	Medical complications	Test or equipment complications	Nutrition	Other
Agoritsas et al. (2005)	S	X	X	X	X	X	X	X	X	X	X		X
Armitage et al. (2018)	S	X											X
Collins et al. (2020)	A			X			X						X
Davis et al. (2013)	S	X	X	X	X	X	X	X	X	X	X	X	X
Eden et al. (2017)	P												X
Fernando et al. (2021)	S			X	X	X				X
Fowler et al. (2008)	S	X		X	X	X	X		X	X	X
Giardina et al. (2020)	S	X	X	X					X				X
Haldar et al. (2020)	S	X	X	X							X	X	X
Hasegawa et al. (2011)	S	X							X		X	X	X
Hill et al. (2010)	I					X
Kaboli et al. (2010)	I	X
Kalisch et al. (2014)	S	X		X		X	X			X
Laukkavirta et al. (2020)	IC	X		X					X
Levtzion‐Korach et al. (2010)	C	X											X
Marsall et al. (2024)	S	X								X
O'Hara et al. (2018)	S	X		X							X	X	X
O'Hara et al. (2017)	S/P/I	X											X
Reader and Gillespie (2021)	C	X	X										X
Sarpong et al. (2025)	S	X		X		X	X						X
Schmid et al. (2009)	I					X
Schmidt (2004)	S			X	X		X			X
Schnock et al. (2022)	A	X		X		X							X
Schwappach (2008)	S/I	X		X	X	X		X	X		X		X
Sutton (1994)	I					X							X
Van Melle et al. (2016)	I		X							X
Walton et al. (2017)	S		X	X	X	X		X		X	X	X	X
Wan et al. (2023)	S/I			X	X
Weingart et al. (2005)	S/I	X			X			X	X		X		X
Weissman et al. (2008)	I	X		X	X	X	X		X
Yan et al. (2017)	S	X	X	X	X	X	X	X	X	X	X		X

Abbreviations: A, web application; C, patient complaints; I, interview; IC, insurance charts; P, phone line; S, survey.

4.5. Have Patients With Communication Support Needs Been Included in Patient or Carer Reported Safety Research to Date?

Participant inclusion and exclusion criteria provided a clear indication of who was included and excluded from each study. In 19 of the studies, there were no explicit criteria reported about the inclusion or exclusion of patients who needed support to communicate (e.g., patients with aphasia, low health literacy) (Eden et al. 2017; Giardina et al. 2020; Hasegawa et al. 2011; Hill et al. 2010; Kaboli et al. 2010; Laukkavirta et al. 2020; Levtzion‐Korach et al. 2010; Marsall et al. 2024; Reader and Gillespie 2021; Wan et al. 2023; Schmid et al. 2009; Collins et al. 2020; Davis et al. 2013; Schnock et al. 2022; Schwappach 2008; Van Melle et al. 2016; Walton et al. 2017; Weissman et al. 2008; Haldar et al. 2020). Nine studies reported excluding patients from participation due to specific communication support needs (Agoritsas et al. 2005; Fowler et al. 2008; Kalisch et al. 2014; O'Hara et al. 2018; Schmidt 2004; Sutton 1994; Sarpong et al. 2025; Armitage et al. 2018; Weingart et al. 2005), with eight of these excluding patients if they were unable to speak the same language in which the study was being conducted (Agoritsas et al. 2005; Fowler et al. 2008; Kalisch et al. 2014; O'Hara et al. 2018; Schmidt 2004; Sutton 1994; Sarpong et al. 2025; Armitage et al. 2018). Patients who were unable to read or write were excluded from participating in the survey conducted by Agoritsas et al., (Agoritsas et al. 2005) and patients who had language or speech (tracheostomy) difficulties were excluded from participating in interviews conducted by Weingart et al., (Weingart et al. 2005) (see Table 6). Conversely, four studies included communication supports to facilitate the participation of patients with communication support needs in the research process (Kalisch et al. 2014; O'Hara et al. 2018, 2017; Weingart et al. 2005). Other exclusion criteria listed were, patients with cognitive difficulties (e.g., confused or unable to make judgements) (Fernando et al. 2021; Yan et al. 2017; Sarpong et al. 2025; O'Hara et al. 2017; Weingart et al. 2005) and patients who were judged to be too unwell to participate (Agoritsas et al. 2005; Fernando et al. 2021; Hasegawa et al. 2011; O'Hara et al. 2018, 2017; Sutton 1994; Wan et al. 2023; Sarpong et al. 2025; Armitage et al. 2018; Collins et al. 2020; Weingart et al. 2005). Within both criteria, patients with communication support needs were likely excluded as patients with cognitive difficulties and those who are very unwell often have communication difficulties (Ludwig et al. 2020).

TABLE 6.

Exclusion criteria for each study.

First author	Acutely unwell	Passed away OR Likely to pass away	Unable to speak in the language of the study	Unable to Consent	Cognitive Impairment or Confusion	Unavailable or in contact precautions	Not at home, resides in a nursing home, or out of state or country	Patients in psychiatric OR obstetrics care
Agoritsas et al. (2005)	X	X	X				X
Armitage et al. (2018)	X		X	X
Collins et al. (2020)	X
Davis et al. (2013)
Fernando et al. (2021)	X	X		X	X	X	X
Fowler et al. (2008)			X				X	X
Hasegawa et al. (2011)	X							X
Hill et al. (2010)
Kaboli et al. (2010)			X
Kalisch et al. (2014)
Marsall et al. (2024)							X
O'Hara et al. (2018)	X		X
O'Hara et al. (2017)	X				X	X
Sarpong et al. (2025)			X		X			X
Schmid et al. (2009)						X
Schmidt (2004)			X
Sutton (1994)	X		X			X
Walton et al. (2017)		X				X
Wan et al. (2023)		X						X
Weingart et al. (2005)	X				X	X	X
Yan et al. (2017)					X	X

Note: X indicates exclusion from the study based on the listed criteria.

In relation to consent to participate, O'Hara et al. (2018) altered the consent process for participation in interviews where participants had low literacy or difficulties with vision. In three studies, support was available to facilitate participation in data collection for patients with difficulties reading or writing (Kalisch et al. 2014) and when the study language and the participant language differed (O'Hara et al. 2017; Weingart et al. 2005). Where participants had difficulties reading or writing, Kalisch et al., (Kalisch et al. 2014) had a research assistant supporting the patient to complete the survey. Interpreters were available to support patients to participate when the study language and participant language differed (O'Hara et al. 2017; Weingart et al. 2005) and a translated participant information pack was available in O'Hara et al. (2017). Relatives or carers were invited to participate as alternative reporters of patient safety incidents where the patient was unable in Kaboli et al., (Kaboli et al. 2010) and Marsall et al., (Marsall et al. 2024).

In six of the 31 studies, the limitations of excluding patients, including those with communication support needs and their carers, were discussed (Fernando et al. 2021; Fowler et al. 2008; Hasegawa et al. 2011; Sutton 1994; Armitage et al. 2018; O'Hara et al. 2017). In these studies, authors reported that the exclusion of critically ill patients, those unable to speak, those with limited ability to speak the language in which the study was being conducted, or who had cognitive difficulties may have led to underreporting of the rate of incidents, given these populations were more likely to experience a patient safety incident.

5. Discussion

This scoping review demonstrates that patients and carers can use a variety of methods including interview, survey and real time reporting via phone and web‐based apps to report patient safety incidents during inpatient admissions. Survey and interviews continue to be the most prominent and effective methods for eliciting reports of patient safety incidents in hospitals across the 12 categories described in Table 4. The fact that more than half of the final yield of studies in this review were published in the 10 years since the last systematic review (Harrison et al. 2015) demonstrates ongoing interest in involving patients and carers in reporting patient safety incidents, and recognition that the information they provide is crucial to reducing patient harm (Harrison et al. 2015; Sahlström et al. 2018; Kinnunen and Sarantob 2013). Since previous reviews (Ward and Armitage 2012; King et al. 2010; Harrison et al. 2015; Kinnunen and Sarantob 2013), studies investigating patient safety incidents reported by patients and carers are increasingly including a range of clinical specialties, however, general medical and surgical clinical specialties continue to be the most represented.

Surveys were the only method that captured reports of patient safety incidents from patients or carers across all 12 categories. Certain patient safety incidents, such as those relating to blood, nutrition and patient identification, were only detected when a survey was used, or where the interview contained questions specific to those incidents. Whereas incidents in categories such as medication errors and the ‘other’ category (e.g., consent; delays in care delivery and uncontrolled pain) were elicited by multiple methods. This finding may be due to the differing views that patients and carers have on what constitutes a patient safety incident (Harrison et al. 2015) and the inconsistency in timing of eliciting reports of patient safety incidents which may influence recall of the details of the incident (Fowler et al. 2008; Kaboli et al. 2010). The effectiveness of a survey to elicit reports of patient safety incidents across all 12 categories may be due to the ability to prompt recall of incidents and the fact that a survey can utilize tailored questions to ensure incidents from a range of categories are captured. This finding suggests that there is value in a method of eliciting reports of patient safety incidents that includes prompting for targeted categories of incidents. However, the opportunity for additional open‐ended questions may also be valuable. Open‐ended questions could capture the details of the patient safety incident which may provide insights into mitigation strategies. Using a range of methods to elicit reports of patient safety incidents may be beneficial to patients more vulnerable to experiencing these incidents, including those with communication support needs. Employing a variety of methods would allow for a tailored approach to suit an individual's specific communication support needs. For example, a survey on an online platform would allow a person to utilize the accessibility functions within the device, whilst still facilitating the reporting of a wide range of incidents (Kinnunen and Sarantob 2013).

The engagement of patients and families in the delivery of safe health care is underpinned by the World Health Organization's Global Patient Safety Action Plan 2021–2030 guiding principles (World Health Organisation 2021). However, as discussed in previous studies, there is an ongoing issue in patient reported safety literature relating to the lack of inclusion of patients who are the most vulnerable to experience harm, particularly patients with communication support needs (e.g., older patients with sensory loss, those with acquired communication disability such as aphasia, or poor language proficiency) (Ward and Armitage 2012; Bartlett et al. 2008; Divi et al. 2007; Fowler et al. 2008; Weissman et al. 2008; Long et al. 2013). These patients are commonly excluded from many forms of health‐related research (Hemsley et al. 2019; Shiggins et al. 2024; Killett et al. 2023). Although the studies in this review included patient and carer reports of patient safety incidents across 30 different clinical specialties, few clinical specialties were included that have high rates of patients with aged‐related communication support needs (e.g., geriatric wards) and other patients with communication support needs (e.g., stroke or neurology wards). Furthermore, the average age of included participants, being 59.4 years, means they are more likely to be able to communicate without requiring additional support. In the four studies that did include accommodations for participants with communication support needs, these were related to low literacy and access to interpreters. None of the studies explicitly reported including or making accommodations to facilitate inclusion of patients with communication disability. The studies included in this review are therefore unlikely to be representative of the range of patients at higher risk of experiencing a patient safety incident.

There is increasing awareness about the importance of including patients with communication support needs in patient experience and patient safety research (Ward and Armitage 2012; O'Halloran et al. 2019; Fowler et al. 2008; Weissman et al. 2008; Shiggins et al. 2022). Whilst four studies in this review provided accommodations for participants with communication differences (e.g., through translating materials) there were no examples of accommodations made for participants with communication disabilities. To be representative of the population most vulnerable to patient safety incidents in hospital, patients who have communication support needs should be included in reporting experiences of patient safety incidents, across all seven elements of the research process. To strengthen the reporting of this body of research, authors should report on how eligibility criteria that require the ability to communicate are determined, document the communicative demands of all aspects of the research and report on the communication supports that were provided to facilitate the participation of patients with different communication support needs (O'Halloran et al. 2019; Shiggins et al. 2022).

This scoping review has limitations. Firstly, three concepts were used to direct our search. These were related to patient safety incidents, the participation of patients or carers and inpatient care. It is possible that the use of the terms relating to all three concepts has resulted in the exclusion of relevant studies. Additionally, information available outside published literature (e.g., grey literature, websites) was outside the scope of our review. Examining these may provide further insight into the methods used to elicit patient and carer reports of patient safety incidents and ways to include patients most vulnerable to experiencing these incidents. There may be studies that describe reporting of patient safety incidents by vulnerable patients in settings other than hospital that may provide valuable insights into how these patients can be included in research across the continuum of care. Finally, authors of the studies were not contacted to gather more information to determine if accommodations were made in the study protocols to facilitate the inclusion of patients with communication disability which may have provided further insights. However, this review provides researchers and hospital managers information relating to effective methods to elicit reports of patient safety incidents from patients and carers. Further, this information s may facilitate the inclusion of patients who are most vulnerable to experiencing these incidents in hospital.

6. Conclusion

Patients and their carers are in a unique position to be able to provide valuable insights into safety incidents experienced in hospital. Surveys were the most common method used to elicit reports of patient safety incidents in hospital, and this method captured incidents across all 12 categories. Methods to elicit reports of safety incidents from patients and carers should include both prompted questions to capture incidents across all categories and the opportunity to capture the narrative associated with the incident. The exclusion of patients who have communication support needs and who are most vulnerable to experiencing a patient safety incident is concerning. Future research should focus on including these populations across the entire research process and investigate strategies to support the inclusion of patients who have communication support needs to report patient safety incidents. Their experiences and insights are essential to providing safer care.

Author Contributions

R.S. and R.O. conceptualized the study and contributed to the design of the study. R.S. conducted the search and all authors participated in data collection. R.S. and R.O. participated in data analysis and interpretation. R.S. wrote the initial draft of the manuscript and revised after review by T.R., S.E.L. and R.O. T.R., S.E.L. and R.O. critically reviewed the manuscript. All authors have read and approved the current version.

Funding

The authors have nothing to report.

Disclosure

No AI were used at any stage of this research or manuscript preparation.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1: Medline search strategy.

Data Availability Statement

The authors confirm that the data supporting the findings of this study are available within the article and its Supporting Information.