Engaging Parents in Healthcare Interventions to Improve Paediatric Patient Safety: A Scoping Review.

backgroundPaediatric patient safety incidents remain a significant global concern, with parents often playing a crucial role in detecting and preventing harm. Despite international calls for family partnerships in healthcare, evidence on how to meaningfully engage parents as participants in improvement interventions or within their development is limited.

objectiveTo summarise and describe healthcare interventions that engage parents to improve key paediatric patient safety issues (relating to medication, communication, diagnosis and assessment, documentation, and administrative processes) and to explore the nature of parental engagement within the studies, including as research participants within the interventions themselves and/or the design and conduct of the study.

methodsIn this scoping review five databases (Medline, EMBASE, CINAHL, Web of Science and Scopus) and grey literature were searched for studies published from 2000 to August 2025. Eligible studies (published in English) described interventions aimed at mitigating key patient safety issues and engaged parents within the intervention and/or the wider study design. Data were independently charted and synthesised narratively using the Patient and Family Engagement (PFE) framework and the International Association for Public Participation (IAP2) Spectrum.

results111 studies were included, predominantly from secondary care settings (n = 89, 80%), conducting experimental study designs (n = 43, 39%) or quality improvement projects (n = 36, 32%). Communication and medication safety were the most frequently targeted areas (n = 72, 65% and n = 55, 50%, respectively). Interventions were categorised into 17 groups, totalling 179 interventions, most commonly involving process standardisation (n = 26/111, 23%) or parent-targeted education (n = 25/111, 23%). Outcome measures largely reported parent-specific factors, such as their perception (n = 38/111, 10%) or knowledge (n = 21/111, 19%), with minimal evaluation of real-world safety outcomes. Parental engagement within healthcare interventions was focused on Direct Care (n = 108, 97.3%) and most commonly occurred through consultation-based approaches (n = 78, 70.3%). Parental engagement within research activities was primarily classified as Inform (n = 66, 59.5%), suggesting limited involvement in research design, development, or delivery.

conclusionParental engagement is essential to improving paediatric patient safety, yet it remains limited, inconsistent, and often tokenistic. Greater partnership with parents is needed, both as contributors to research and as partners in the design and delivery of healthcare services and safety interventions. Embedding engagement within research and quality improvement, alongside standardised approaches to its evaluation and reporting, will be critical to achieving a more inclusive, human-centred approach in which parental perspectives meaningfully shape safer paediatric care. PATIENT AND PUBLIC CONTRIBUTION: The parent patient and public involvement and engagement (PPPIE) contributor for this study met with the principal investigator on several occasions to review the findings and shape the interpretation of the results. They contributed to reviewing and editing the manuscript to improve clarity and accessibility.