Family-Centered Patient Safety Toolkit: Improving Communication and Error Reporting

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A curated set of tools and resources to support family engagement, communication, and safety based on the following research:

Families as Partners in Hospital Error and Adverse Event Surveillance

Patient Safety After Implementation of a Coproduced Family Centered Communication Programme: Multicenter Before and After Intervention Study

Description

The American Academy of Pediatrics (AAP) underscores the critical role of patients, families, and pediatricians as partners in the healthcare team, particularly in advancing patient safety within hospital settings. Diverse perspectives across these groups are essential to delivering safe, high-quality care.

While medical errors and adverse events remain prevalent, evidence shows they can be reduced through meaningful engagement of patients and families across the full continuum of care. Strengthening these partnerships improves communication, supports shared decision-making, and enhances safety outcomes.

Although numerous resources and strategies exist to support family engagement, hospitals vary in capacity and readiness. This toolkit is designed to be adaptable, enabling organizations to prioritize and implement strategies aligned with their current level of engagement maturity.

To provide focus and practical guidance, the toolkit highlights six key areas of impact:

How to Use This Toolkit

To get started, identify the topic you would like to explore in the list below.

Use this toolkit as a guide to inform your practice, it is not a substitute for clinical expertise or professional judgment. As you apply the resources, be sure to document your approach and revisit your progress regularly. Follow an ongoing improvement cycle: Implement → Measure → Adjust → Sustain.

Family Centered Rounds

Opportunities to Improve Patient/Family Engagement on Rounds

Implement Patient and Family Centered I-PASS Program for Family-Centered Rounds
- Patient and Family Centered I-PASS (Family-Centered Communication Program to Reduce Medical Errors and Improve Family Experience and Communication Processes – this resource describes a framework for family-centered rounds which emphasizes family engagement, nurse engagement, health literacy and structured verbal and written communication organized around I-PASS framework, including illness severity from the family perspective and synthesis by family.
- Patient & Family Centered I PASS SCORE Program – a structured training and educational program supporting family-centered I-PASS communication on rounds.
- Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios - provides a framework for sites to implement Patient and Family Centered I-PASS rounds through an innovative nurse-family-physician ("Mentor-Trio") coaching model.

Additional FCR Tools and Resources

Family Engagement Self-Assessment Tool (FESAT) – A self-assessment tool to help organizations reflect on readiness and approach to family engagement.
Engagement Guide (Resource: Guide to Patient and Family Engagement in Hospital Quality and Safety) – An evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety.
Reflecting Our Community: A Toolkit for Strengthening PFACs – This toolkit contains guidance and resources to help hospitals advance and strengthen Patient and Family Advisory Councils (PFACs) to better reflect and support the hospital and communities served.
The Family-Centered Rounds (FCR) Toolkit – Another model for FCR which includes a checklist and associated training curriculum.
Family Centered Rounds (FCR) Behaviors & Staff Role Expectations – A toolkit with a collection of materials that includes an FCR checklist and associated training curriculum.
Family-Centered Rounds Checklist – A practical tool designed to guide healthcare teams during bedside rounds, ensuring meaningful family engagement, clear communication, and shared decision-making. It promotes best practices such as introducing team members, inviting family participation, using understandable language, addressing concerns, discussing care plans and discharge needs, and confirming understanding to support patient- and family-centered care.

Handoffs

Strategies to Implement I-PASS Handoffs

I PASS Handoff Curriculum (Training Module) – an educational module designed to support training in I-PASS communication practices. This helps build shared understanding and consistency in how I-PASS is used across teams.
I PASS Handoff Curriculum: Educational Module / Simulation – Simulation based module supporting training in I-PASS communication practices.
I PASS Mentored Implementation Handoff Curriculum – an implementation guide and mentored curriculum supporting consistent I-PASS adoption. This helps with providing structured support for spreading and sustaining I-PASS practice across teams.
I PASS Handoff Curriculum: Campaign Toolkit – A campaign toolkit designed to support adoption, engagement, and spread of I-PASS practices. This helps teams reinforce I-PASS behaviors through shared messaging, visuals and structured rollout approaches.

Additional Communication Resources

AHRQ’s Toolkit for Engaging Patients to Diagnostic Safety – designed for outpatient and office-based practices using two strategies: helping patients prepare and communicate clearly and helping clinicians actively listen during the first minute of the visit.
I PASS Faculty Observation Tools – A collection of structured tools to observe and provide feedback on I-PASS handoff and communication practices.
TeamSTEPPS® - An evidence-based set of teamwork tools. It is aimed at optimizing patient outcomes by improving communication and teamwork skills among healthcare teams, including patients and family caregivers.

Incident Reporting

Strategies for Engaging Families in Safety Reporting

AHRQ’s Toolkit for Engaging Patients to Diagnostic Safety – designed for outpatient and office-based practices using two strategies: helping patients prepare and communicate clearly and helping clinicians actively listen during the first minute of the visit.
A Coproduced Family Reporting Intervention to Improve Safety Surveillance and Reduce Disparities – A mobile reporting tool for families, along with family and staff education, and a process for sharing comments and learnings in real-time with unity and hospital leaders.
Filling a Gap in Safety Metric: Development of a Patient-Centred Framework to Identify and Categorise Patient-Reported Breakdowns Related to the Diagnostic Process in Ambulatory Care – A guide for improving communication by emphasizing the importance of patient feedback in the diagnostic process. The article is especially useful for strengthening active listening, shared decision-making, and feedback-driven communication practices in outpatient care.
Families as Partners in Hospital Error and Adverse Event Surveillance: This article escribes a framework for incorporating family safety reporting interviews into existing research and operational safety surveillance methods.

Other Safety Measurement Related Resources

Communication and Optimal Resolution (CANDOR) – A framework and tools for transparent communication and resolution after harm. This tool supports trust, learning, and accountability when adverse events occur.
Disclosure of Adverse Events Toolkit – Policy Appendix – A toolkit that provides guidance and supporting materials for disclosure conversations with patients and families.
When Things Go Wrong: Responding to Adverse Events – This details the management of the adverse events: elements of hospital incident policy, initial response to the event, analysis of the event, documentation and reporting.
Improving Root Cause Analyses and Actions to Prevent Harm – this tool describes best practices for conducting a comprehensive root cause analysis and actions (RCA2) to improve patient safety
IHI Global Trigger Tool for Measuring Adverse Events – this paper provides information on the development and methodology of the IHI Global Trigger Tool, enabling the ability to accurately identify adverse events (harm) and measure the rate of adverse events over time
Measure Dx: A Resource to Identify, Analyze, and Learn from Diagnostic Safety Events – designed to identify gaps in diagnostic safety and gain insights for improvement. This can be used by any healthcare organization interested in promoting diagnostic excellence and reducing harm from diagnostic safety events.
Equity-Focused Safety Surveillance – This provides analysis and resources examining inequities in patient safety and approaches to integrating equity into safety reporting and response

Care Coordination

Care Coordination strategies and frameworks

Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems: This American Academy of Pediatrics policy statement provides a definition and framework for implementing care coordination.
Pediatric Care Coordination Curriculum An Interprofessional Resource to Effectively Engage Patients and Families in Achieving Optimal Child Health Outcomes 2ND EDITION – An interprofessional framework for delivering patient- and family-centered care coordination in pediatric settings. The curriculum covers core principles, practical tools, communication strategies, care planning, quality improvement, and family engagement techniques to support optimal health outcomes for children and youth, particularly those with complex healthcare needs.
Integrated Care at Boston Children's Hospital – Creates and Validates processes, tools, and measures that improve the integration of patient care.
Medical Home Care Coordination Resources – A collection of tools and resources for a variety of individuals including pediatric clinicians, state agencies (Medicaid, Title V), family advocates, family/professional partnership groups, and other pediatric medical home stakeholders interested in care coordination.

Other Care Coordination Resources

Care Coordination Measurement Tool (CCMT) – A framework and measures describing effective, family-centered care coordination.
Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems – A framework for high-performing pediatric care coordination.
National Center for Care Coordination Technical Assistance: This provides technical assistance to any entity focused on pediatric care coordination capacity building and measurement.
Validation of a Parent-Reported Experience Measure of Integrated Care: A survey that can be used in quality improvement efforts to measure family-reported experience of pediatric care integration.
Care Mapping: A site that provides a comprehensive snapshot of a family’s needs and enables the care team to appreciate how each of these aspects relate to each other.
Patient & Family Engagement Getting Started Toolkit on Improving Health and Advancing Equity – A toolkit designed to help health systems, care providers and their organizations to shift cultures and practices to be more person-centered in ways that engage patients and families, improve health and advance equity. It includes resources to help advocate for and implement effective PFE strategies.

Culture of Safety

Resources to Support a Just Culture

Leading a Culture of Safety: A Blueprint for Success and Leader Rounding – this guide provides chief executive officers and other health care leaders with high level strategies and practical tactics for assessing and advancing their organization’s culture of safety.
Family Centered Rounds (FCR) Behaviors & Staff Role Expectations – this toolkit is a collection of materials that includes an FCR checklist and associated training curriculum.
SOPS Surveys – Surveys that asks healthcare providers and other staff in hospitals, medical offices, nursing homes, community pharmacies, and ambulatory surgery centers about their organizational culture's support for patient safety. The surveys can be used to raise awareness of and improve patient safety culture in different organizational settings.

Acknowledgement

This program was funded through a Patient- Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI Engagement Award (EADI - 42361). The views, statements, opinions presented in this work are solely the responsibility of the author(s) and do not necessarily represent the views of PCORI®, its Board of Governors or Methodology Committee.

The American Academy of Pediatrics would like to acknowledge the following expert workgroup members who have dedicated their time, energy, and expertise to the development of this toolkit. They have been instrumental in identifying and reviewing implementation resources to support Family-Centered Patient Safety

Alisa Khan, MD, MPH, FAAP
Christopher P. Landrigan, MD, MPH
Irina Topoz, MD, FAAP
Joe Grubenhoff, MD, MSCS
Trisha Marshall, MD, MSc

Disclaimer: Some tools and resources were developed by entities other than the AAP. These tools are in the public domain and reproducible with permission and/or acknowledgment, and they are referenced in this toolkit for the convenience of its users. Inclusion in this toolkit does not imply an endorsement by the American Academy of Pediatrics. Any tools and resources developed by other entities do not represent AAP policy or guidelines. They are provided only as a reference for clinical practices interested in implementing diagnostic safety practices. This is not a substitute for medical care.

Last Updated

06/17/2026

Source

American Academy of Pediatrics

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