Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial

Abstract

Educating staff and facilitating discussion about patient safety culture in their own practice leads to increased reporting of incidents. It is beneficial to invest in a team-wise effort to improve patient safety.

Improving patient safety culture in general practice: an interview study

“…The combination of a questionnaire with a workshop was found to be significantly more effective than the questionnaire alone when using incident reporting as a proxy for openness and safety culture. 15 Compared with the control group, the workshop group reported 42 times more incidents, whereas the questionnaire group reported five times more incidents, measured 1 year after the intervention. In addition, incidents were more often analysed systematically and patient safety was more often on the team meetings' agenda.…”

“…14,15 The first intervention was administering a patient safety culture questionnaire, the SCOPE questionnaire. 23 Participants in this intervention are referred to as being in the SCOPE group (Box 1).…”

Patient safety: the general practice agenda

“…2 Previous Care Quality Commission work has identified frequent patient safety risks from medicines reconciliation post-hospital discharge, 3 and Avery's work on medication errors has firm data from general practice. 4 Thirdly, delayed diagnosis has had recent attention, which may have both safety and quality issues in its causal pathway; 5 8,9 and routine use of checklists. 10 Verbakel and colleagues 8 and Milligan et al 9 also explicitly refer to the importance of the organisational safety culture, the former using a validated tool (the 'MaPSaF') 11 which can be applied by practices as a measure of their own safety culture and its dimensions.…”

“…4 Thirdly, delayed diagnosis has had recent attention, which may have both safety and quality issues in its causal pathway; 5 8,9 and routine use of checklists. 10 Verbakel and colleagues 8 and Milligan et al 9 also explicitly refer to the importance of the organisational safety culture, the former using a validated tool (the 'MaPSaF') 11 which can be applied by practices as a measure of their own safety culture and its dimensions. Waller et al's 7 article links safety awareness with quality improvement, and shows encouraging data from patients whose perception of their GPs' care in an Australian setting was very positive.…”

“…The enthusiasts who developed and piloted Bowie and colleagues' checklist 10 can be contrasted with the nursing home staff who, in Milligan et al's words, 9 underreported medication errors because they would then be 'perceived to be negative in terms of external perceptions of the quality of care being delivered ...'. Verbakel 8 showed increased reporting of safety issues when primary care teams were prompted by a survey raising the issue, and a much stronger response when practice staff voluntarily undertook an educational workshop. The latter appears to have included design features known to maximise educational impact and application of learning, 13 and greatly increased reporting activity, although the sample was small and the actual detail of behavioural alterations at practice level are sadly not reported.…”