Adverse events reporting during the COVID-19 pandemic in a Danish region: a retrospective analysis.

The 2020 onset of the COVID-19 pandemic globally strained healthcare. Healthcare systems worldwide had to rapidly reorganize, impacting service delivery, patient care, and care-seeking behaviors. This left little time to assess the pandemic's effects on patient safety. This paper investigates COVID-19's influence on patient safety in a Danish region, using data from the national reporting system for adverse events during the initial COVID-19 surge in early 2020. This retrospective analysis investigated how the early phase of the COVID-19 pandemic (January-September 2020) affected the incidence of adverse events in a Danish Region, comparing it to the same period in 2019. Data were sourced from the Danish Patient Safety Database and regional systems. Adverse events were reported numerically. Descriptive statistics were employed to describe the percentage difference in adverse events and hospital activity, as well as the rate of adverse events per 1000 activities. Additionally, COVID-19-specific adverse events from April 2020 to March 2021 were identified and analyzed, categorizing them into seven risk areas across various healthcare sectors. During Denmark's initial COVID-19 surge in early 2020, the North Denmark Region's hospitals reported a significant decrease in adverse events, with a 42.5% drop in March 2020 compared to March 2019. From January to September 2020, the number of adverse events dropped 8.5% compared to the same period in 2019. In the same period, hospital activity declined by 10.2%. The ratio of reported adverse events per 1000 hospital activities thus decreased in early 2020 but showed only a minor difference overall for January-September compared to 2019. Between April 2020 and March 2021, out of 5703 total adverse events, 324 (5.7%) were COVID-19 related. COVID-19-related events were categorized into seven distinct risk areas, reflecting diverse impacts across healthcare sectors including hospitals, general practices, pre-hospital care, and specialized services. The initial decline in reporting of adverse events likely resulted from rapid healthcare changes and under-prioritization of the reporting system during the acute phase. However, a near return to pre-pandemic reporting levels suggests a resilient reporting system despite the crisis. The study's strength lies in the comprehensive data from Danish reporting systems, though it acknowledges potential underreporting and doesn't measure the pandemic's overall impact on patient safety.

Innovative rehabilitating meal service programs for old people living at home: A randomized controlled pilot study.

OBJECTIVE: To test the feasibility of a pilot study for a future definitive trial investigating the effect of different meal service programs for old people living at home. DESIGN: An 8-week randomized controlled trial was performed. SETTING: Three municipalities in the Nordic country, Denmark. SUBJECTS: Danish participants (≥65y) with reduced functionality. INTERVENTION: Three different meal service programs 1) 24-h meals service, 2) Protein-rich meal service, and 3) Rehabilitation meal service, were developed and compared to standard care. MAIN MEASURES: The main outcome was study feasibility. Dietary intake, anthropometry, physical function, quality of life, readmissions and adverse events were also evaluated. Comparisons between participants receiving a meal service program and standard care were done by one-way ANOVA, chi-square test and Fishers exact test. RESULTS: A total of 592 subjects were assessed for eligibility and 13% (76/592) were recruited. Final analysis included 75% (57/76) of participants. The outcome measures seemed acceptable and feasible though eligibility, inclusion, and completion of the intervention were lower than expected. The 24-h meal service program managed to significantly increase the intake of protein (p = 0.049) and energy (p = 0.038) compared to the control group where reductions were seen. No other significant differences were found. CONCLUSIONS: The pilot study was feasible and several benefits for completers were seen. However, in a future definitive trial, inclusion criteria should be wider, more effort should be put on the time, training and focus of the personal in close contact to the older subjects and the intervention should be less comprehensive and more flexible.