Systematic psychometric review of self‐reported instruments to assess patient safety culture in primary care

Desmedt, Melissa; Bergs, Jochen; Vertriest, Sonja; Vlayen, Annemie; Schrooten, Ward; Hellings, Johan; Vandijck, Dominique

doi:10.1111/jan.13464

Cited by 11 publications

(11 citation statements)

References 42 publications

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“…Particular staff safety climate survey with the most evidence of validity and reliability were the PC SafeQuest, Frankfurt Patient Safety Climate Questionnaire (FraSiK) and SCOPE. It was suggested that rather than developing new surveys, researchers should focus on improving the psychometric properties of existing tools [ 15 , 24 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…One review [ 16 ] included a study concerned with identifying lessons learned from error, and another review included studies on the use of safety culture data to inform risk management and feedback in order to inform improvement efforts [ 19 ]. A number of the reviews also concluded that safety data should be used to inform patient safety improvement [ 16 , 19 ], and there was a need to triangulate safety data from multiple sources [ 15 , 20 , 21 , 26 , 27 ]. However, it was suggested that the recruitment of patients to complete patient report measures may add another layer of difficulty that may reduce the use of such measures [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, there is still a need to improve the psychometric properties of many of these methods for MMS [ 15 , 18 , 20 , 23–26 ]. Therefore, with the exception of the sensitivity to operations dimension of safety, rather than developing new methods of MMS, there should instead be a focus on using and adapting existing methods of MMS in order to increase generalizability and comparability [ 15 , 18 , 24 , 26 ]. There is also a need for multi-methods approach to measuring safety to assess safety across each of the five dimensions of safety described by Vincent et al .…”

Section: Discussionmentioning

confidence: 99%

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A meta-review of methods of measuring and monitoring safety in primary care

O’Connor

Madden

O’Dowd

et al. 2021

International Journal for Quality in Health Care

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Background A major barrier to safety improvement in primary care is a lack of safety data. The aims of this unfunded systematic meta-review (registration: CRD42021224367) were to: identify systematic reviews of studies that examine methods of measuring and monitoring safety in primary care; classify the methods of measuring and monitoring safety in the included systematic reviews using the five safety domains in Vincent et al.’s framework; and use this information to make recommendations for improving the measurement and monitoring of safety in primary care. Methods Four databases (Medline, Academic Search Complete, Web of Science and CINAHL), and the grey literature were screened in November 2020 and November 2020, and searches were re-run in January 2021, with searches updated in January 2021. Systematic reviews were included if they: addressed measures of patient safety in primary care; and were published in English. Studies were assessed using the Critical Appraisal Skills Programme for systematic reviews. Results A total of 6,904 papers were screened, with 13 systematic reviews included. A commonly reported method of measuring past harm was through patient record review. The most frequent methods for assessing the reliability of safety critical processes were checklists, observations, and surveys of staff. Methods used to assess sensitivity to operations included observation, staff surveys, interviews, focus groups, active monitoring, and simulated patients. Safety climate surveys were a commonly used as an approach to assess anticipation and preparedness. A number of the reviews concluded that safety data could, and should, be used for integration and learning. The main limitation of the meta-review was that it was of systematic reviews only. Conclusions Many of the methods for measuring and monitoring safety are readily available, quick to administer, do not require external involvement, and are inexpensive. However, there is still a need to improve the psychometric properties of many methods. Researchers must support the development of psychometrically sound safety measures that do not over burden primary care practitioners. Policy makers must consider how primary care practitioners can be supported to implement these measures.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A meta-review of methods of measuring and monitoring safety in primary care

O’Connor

Madden

O’Dowd

et al. 2021

International Journal for Quality in Health Care

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“…Enhancing the quality of hospital services by improving patient safety culture is an increasing focus of practical action and research interest in health systems. 1 2 The quality of health services can be improved through embedding a safe and reliable culture, supported by managers who understand its influence on organisational performance, including clinical outcomes. 3 4 However, there is limited literature investigating the interaction between patient safety culture and patient experience, unlike the extensive research on these concepts individually.…”

Section: Introductionmentioning

confidence: 99%

Relationship between patient safety culture and patient experience in hospital settings: a scoping review protocol

et al. 2021

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IntroductionHospitals commonly examine patient safety culture and other quality indicators to evaluate and improve performance in relation to quality and safety. A growing body of research has separately examined relationships between patient safety culture and patient experience on clinical outcomes and other quality indicators. However, there is a knowledge gap regarding the relationship between these two important domains. This article describes the protocol for a scoping review of published literature examining the relationship between patient safety culture and patient experience in hospital settings. The scoping review will provide an overview of research into the relationship between patient safety culture and patient experience in hospital contexts, map key concepts underpinning these domains and identify research gaps for further study.Methods and analysisThe scoping review will be conducted using the five stages of Arksey and O’Malley’s framework: identify the research question; identify relevant studies; study selection; chart data; and collate, summarise and report the results. The inclusion criteria will be applied using the Population, Concept and Context Framework. Searches will be conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, Scopus and SciELO databases, without applying date range limits. Hand-searching of grey literature will also be performed to find relevant, non-indexed literature. Data will be extracted using a standardised data extraction form developed by the Joanna Briggs Institute. Both descriptive and thematic analyses will be undertaken to scope key concepts within the body of reviewed literature.Ethics and disseminationThis type of study does not require an ethics review. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.

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“…The Joint Commission describes safety culture as a healthcare organization’s values, commitment, competencies, and actions in pursuit of patient safety [ 1 ]. Validated safety culture surveys exist for patients and providers in hospitals, pharmacies, nursing homes, and medical offices [ 6 , 7 ]. But patient safety survey implementation has lagged within academic settings [ 8 ], including programs that provide training in spinal manipulative therapy (SMT).…”

Section: Introductionmentioning

confidence: 99%

Patient safety in chiropractic teaching programs: a mixed methods study

et al. 2020

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Background Patient safety research has lagged within academic settings, including chiropractic teaching institutions. To develop a robust patient safety culture, the Institute of Medicine emphasized the need for employee’s attitudes to be understanding and positive. To initiate the assessment of the current culture and future needs, this study evaluated patient safety attitudes among chiropractic teaching clinic stakeholders (supervising clinicians, student interns, and administrative staff) and compared their standardized survey scores to established medical survey databases. Methods We conducted a cross-sectional, mixed methods survey design with quantitative analytic priority. Chiropractic interns, clinical faculty, and clinic staff of 5 international chiropractic educational programs completed a modified version of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Culture for Medical Offices Survey with open-ended comment fields between 2014 and 2016. Composite means of positive responses were calculated and compared to patient safety, quality of care, and overall self-ratings benchmarks from Canadian providers and academic settings in the AHRQ database. Qualitative responses were thematically categorized for a convergent analysis of quantitative results for the chiropractic sample. Results Chiropractic survey response rate was 45.3% (n = 645). Quantitative survey results indicated moderate scores and ranges (57–85%) on all patient safety dimensions for the chiropractic samples. Academic medicine and chiropractic providers’ benchmarks scored higher positive responses than chiropractic teaching clinics on most quantitative dimensions, except for work pressure/pace. Teamwork, organizational learning, and patient tracking/follow-up were the most positively endorsed quantitative dimensions, with communication, staff training, office standardization, and leadership support considered areas for improvement in both settings. Qualitative responses for the chiropractic clinics identified a need for open communication; additional staff training and student involvement in creating safety cultures; standardization of office processes including information exchange, scheduling, and equipment maintenance; and leadership support that focused on decreasing work pressure/pace and setting safety priorities. Conclusion As the first report of patient safety attitudes from stakeholders in chiropractic teaching clinics, specific areas of improvement were identified. Chiropractic teaching programs might consider incorporating these and related patient safety concepts into their formal curricula. Mixed methods approach offers teaching clinics opportunities to assess stakeholders’ insights and enhance safe delivery of chiropractic care.

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Systematic psychometric review of self‐reported instruments to assess patient safety culture in primary care

Cited by 11 publications

References 42 publications

A meta-review of methods of measuring and monitoring safety in primary care

A meta-review of methods of measuring and monitoring safety in primary care

Relationship between patient safety culture and patient experience in hospital settings: a scoping review protocol

Patient safety in chiropractic teaching programs: a mixed methods study

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