A Systematic Review of Patient Safety Measures in Adult Primary Care

Hatoun, Jonathan; Chan, Jeffrey; Yaksic, Enzo; Greenan, Mary Alexis; Borzecki, Ann M.; Shwartz, Michael; Rosen, Amy K.

doi:10.1177/1062860616644328

Cited by 14 publications

(14 citation statements)

References 31 publications

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“…25 Collectively, these findings can inform how and what to start measuring patient safety performance in primary care, especially when the number of safety indicators specific to primary care remains limited compared with the inpatient measures. 42,43 The analytic classification of a personnel or patient perspective as nonnarrated does not sufficiently indicate that it is not considered important and/or an element of patient safety to them. This study sought to capture the meanings of patient safety that were most salient to the participants.…”

Section: Discussionmentioning

confidence: 99%

Patient Safety in Primary Care: Conceptual Meanings to the Health Care Team and Patients

et al. 2020

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Introduction: Patient safety in primary care is an emerging priority, and experts have highlighted medications, diagnoses, transitions, referrals, and testing as key safety domains. This study aimed to (1) describe how frontline clinicians, administrators, and staff conceptualize patient safety in primary care; and (2) compare and contrast these conceptual meanings from the patient's perspective. Methods: We conducted interviews with 101 frontline clinicians, administrators and staff, and focus groups with 65 adult patients at 10 patient-centered medical homes. We used thematic analysis to approach coding. Results: Findings indicate that frontline personnel conceptualized patient safety more in terms of work functions, which reflect the grouping of tasks or responsibilities to guide how care is being delivered. Frontline personnel and patients conceptualized patient safety in largely consistent ways. Discussion: Function-based conceptualizations of patient safety in primary care may better reflect frontline personnel and patients' experiences than domain-based conceptualizations, which are favored by experts.

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Section: Discussionmentioning

confidence: 99%

Patient Safety in Primary Care: Conceptual Meanings to the Health Care Team and Patients

et al. 2020

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“…Various factors from different stakeholders and parties involved in healthcare interlock to be measured against one goal: patient outcome. Although the 1999 Institute of Medicine (IOM) report To Err Is Human (Kohn et al., 1999) has significantly accelerated the safety measure development, the systematic review on patient safety by Hatoun and colleagues (Hatoun et al., 2016) revealed that research has yet primarily focused on inpatient care. Nonetheless, ambulatory setting is actually where most medical care is administered and hence should play an increasingly important role regarding patient safety (Montano et al., 2016; Sockolow et al., 2017; Zonana et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services

2020

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Aim To identify factors for and perceived consequences of nursing errors by nursing staff in home care services in correlation with qualification, work experience, working hours and trainings. Background Patient safety has increasingly been brought into focus of politics and care practices over the past few years. However, little evidence has been provided yet on nursing errors in out‐of‐hospital settings. Design A cross‐sectional study. Methods Randomized sample of 107 home care services and 656 nurses and nursing assistants recruited from all 16 federal states in Germany. Results Missing trainings on error management within the past 2 years were identified to be an important factor for mistakes regarding hygienic measures and medication administration. However, most errors arose in documentation without any significant differences in qualification, work experience, training and working hours. Conclusion Findings indicate that insufficient hygiene and medication administration might be reduced by implementing error management trainings on a regular basis in home care services.

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“…Nothing was discovered that was either commonplace or appropriately sophisticated. Similarly, Hatoun et al 48 undertook a systematic review of patient safety measures in adult primary care. They found 21 articles, including a total of 182 safety measures, and classified these into six dimensions: (1) medication management, (2) sentinel events, (3) care co-ordination, (4) procedures and treatment, (5) laboratory testing and monitoring and (6) facility structures/resources.…”

Section: Overall Performance Measurementmentioning

confidence: 99%

Developing and evaluating a tool to measure general practice productivity: a multimethod study

Dawson

Rigby-Brown

Adams

et al. 2019

Health Serv Deliv Res

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Background Systems for measuring the performance of general practices are extremely limited. Objectives The aim was to develop, pilot test and evaluate a measure of productivity that can be applied across all typical general practices in England, and that may result in improvements in practice, thereby leading to better patient outcomes. Methods Stage 1 – the approach used was based on the Productivity Measurement and Enhancement System (ProMES). Through 16 workshops with 80 general practice staff and 72 patient representatives, the objectives of general practices were identified, as were indicators that could measure these objectives and systems to convert the indicators into an effectiveness score and a productivity index. This was followed by a consensus exercise involving a face-to-face meeting with 16 stakeholders and an online survey with 27 respondents. An online version of the tool [termed the General Practice Effectiveness Tool (GPET)] and detailed guidance were created. Stage 2 – 51 practices were trained to use the GPET for up to 6 months, entering data on each indicator monthly and getting automated feedback on changes in effectiveness over time. The feasibility and acceptability of the GPET were examined via 38 telephone interviews with practice representatives, an online survey of practice managers and two focus groups with patient representatives. Results The workshops resulted in 11 objectives across four performance areas: (1) clinical care, (2) practice management, (3) patient focus and (4) external focus. These were measured by 52 indicators, gathered from clinical information systems, practice records, checklists, a short patient questionnaire and a short staff questionnaire. The consensus exercise suggested that this model was appropriate, but that the tool would be of more benefit in tracking productivity within practices than in performance management. Thirty-eight out of 51 practices provided monthly data, but only 28 practices did so for the full period. Limited time and personnel changes made participation difficult for some. Over the pilot period, practice effectiveness increased significantly. Perceptions of the GPET were varied. Usefulness was given an average rating of 4.5 out of 10.0. Ease of use was more positive, scoring 5.6 out of 10.0. Five indicators were highlighted as problematic to gather, and 27% of practices had difficulties entering data. Feedback from interviews suggested difficulties using the online system and finding time to make use of feedback. Most practices could not provide sufficient monthly financial data to calculate a conventional productivity index. Limitations It was not possible to create a measure that provides comparability between all practices, and most practices could not provide sufficient financial data to create a productivity index, leaving an effectiveness measure instead. Having a relatively small number of practices, with no control group, limited this study, and there was a limited timescale for the testing and evaluation. Implications The GPET has demonstrated some viability as a tool to aid practice improvement. The model devised could serve as a basis for measuring effectiveness in general practice more widely. Future work Some additional research is needed to refine the GPET. Enhanced testing with a control sample would evaluate whether or not it is the use of the GPET that leads to improved performance. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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A Systematic Review of Patient Safety Measures in Adult Primary Care

Cited by 14 publications

References 31 publications

Patient Safety in Primary Care: Conceptual Meanings to the Health Care Team and Patients

Patient Safety in Primary Care: Conceptual Meanings to the Health Care Team and Patients

Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services

Developing and evaluating a tool to measure general practice productivity: a multimethod study

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