A Patient Safety Toolkit for Family Practices

Campbell, Stephen; Bell, Brian; Marsden, Kate; Spencer, Rachel; Kadam, Umesh; Perryman, Katherine; Rodgers, Sarah; Litchfield, Ian; Reeves, David; Chuter, Antony; Doos, Lucy; Ricci‐Cabello, Ignacio; Gill, Paramjit; Esmail, Aneez; Greenfield, Sheila; Slight, Sarah P; Middleton, Karen; Barnett, Jane; Moore, Michael; Valderas, José M; Sheikh, Aziz; Avery, Anthony J

doi:10.1097/pts.0000000000000471

Cited by 16 publications

(15 citation statements)

References 26 publications

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“…Practices were recruited as part of the broader Patient Safety Toolkit (PST) project [40] a process facilitated by the National Institute for Health Research (NIHR) Clinical Research Network (CRN) [41] who contacted every practice across all CCGs, describing the premise of the PST and inviting each to participate. Those practices that expressed an interest were visited by a member of the study team (KM, LD) to discuss the practicalities and benefits of their involvement and ultimately nine were purposively selected [42] to create a sample incorporating a range of list sizes, and socio-economic environments representative of the range of practices found in English primary care [40]. The sample size considered appropriate to provide practical insight into the use of each tool and inform the future development of the patient safety toolkit [40].…”

Section: Participants/recruitmentmentioning

confidence: 99%

“…Those practices that expressed an interest were visited by a member of the study team (KM, LD) to discuss the practicalities and benefits of their involvement and ultimately nine were purposively selected [42] to create a sample incorporating a range of list sizes, and socio-economic environments representative of the range of practices found in English primary care [40]. The sample size considered appropriate to provide practical insight into the use of each tool and inform the future development of the patient safety toolkit [40].…”

Section: Participants/recruitmentmentioning

confidence: 99%

“…Despite a long-standing and increasing awareness of the importance of patient safety and the tools created in its support [60,61] the improvements witnessed in other settings had failed to materialise in primary care [62,63] motivating the development of a comprehensive patient safety toolkit to tackle a range of issues [40]. In its compilation the need to address the importance of safety culture became apparent [30,64] and two tools were identified to fulfil this requirement, PC-SafeQuest and MaPSaF.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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A comparative assessment of two tools designed to support patient safety culture in UK general practice

et al. 2021

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Background The NHS has recognised the importance of a high quality patient safety culture in the delivery of primary health care in the rapidly evolving environment of general practice. Two tools, PC-SafeQuest and MapSaf, were developed with the intention of assessing and improving patient safety culture in this setting. Both have been made widely available through their inclusion in the Royal College of General Practitioners’ Patient Safety Toolkit and our work offerss a timely exploration of the tools to inform practice staff as to how each might be usefully applied and in which circumstances. Here we present a comparative analysis of their content, and describe the perspectives of staff on their design, outputs and the feasibility of their sustained use. Methods We have used a content analysis to provide the context for the qualitative study of staff experiences of using the tools at a representative range of practices recruited from across the Midlands (UK). Data was collected through moderated focus groups using an identical topic guide. Results A total of nine practices used the PC-SafeQuest tool and four the MapSaf tool. A total of 159 staff completed the PC-SafeQuest tool 52 of whom took part in the subsequent focus group discussions, and 25 staff completed the MapSaf tool all of whom contributed to the focus group discussions. PC-SafeQuest was perceived as quick and easy to use with direct questions pertinent to the work of GP practices providing useful quantitative insight into important areas of safety culture. Though MaPSaF was more logistically challenging, it created a forum for synchronous cross- practice discussions raising awareness of perceptions of safety culture across the practice team. Conclusions Both tools were able to promote reflective and reflexive practice either in individual staff members or across the broader practice team and the oversight they granted provided useful direction for senior staff looking to improve patient safety. Because PC SafeQuest can be easily disseminated and independently completed it is logistically suited to larger practice organisations, whereas the MapSaf tool lends itself to smaller practices where assembling staff in a single workshop is more readily achieved.

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Section: Participants/recruitmentmentioning

confidence: 99%

Section: Participants/recruitmentmentioning

confidence: 99%

Section: Comparison With Existing Literaturementioning

confidence: 99%

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A comparative assessment of two tools designed to support patient safety culture in UK general practice

et al. 2021

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“…Many of the mechanisms for improving patient safety focus on health‐care professionals such as systems to track and report errors, regulations and accreditation and work to engage doctors and nurses with patient safety 22‐28 . However, patient and health‐care professional perceptions’ of safety differ.…”

Section: Introductionmentioning

confidence: 99%

Developing a patient safety guide for primary care: A co‐design approach involving patients, carers and clinicians

Morris

Ruddock

Gallacher

et al. 2020

Health Expectations

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Background Patients and carers should be actively involved in patient safety and empowered to use person‐centred approaches where they are asked to both identify safety concerns and partner in preventing them. Objectives The aim of this study was to co‐design a patient safety guide for primary care (PSG‐PC) to support patients and carers to address key patient safety questions and identify key points where they can make their care safer. The objectives were to i) identify when and how patients and carers can be involved in primary care patient safety, and ii) identify the relevant information to include in the PSG‐PC. Design An experience‐based co‐design approach. Setting and Participants We conducted three workshops with patients, carers, community pharmacists and general practitioners to develop and refine the PSG‐PC. Results Participants identified both explicit and implicit issues of primary care patient safety especially relating to technical and relational components of involving patients and carers. The importance of communication, understanding roles and responsibilities, and developing partnerships between patients and health‐care providers were considered essential for actively involving patients in patient safety. Co‐developing the PSG‐PC provided insight to improve care to develop the PSG‐PC. Discussion The PSG‐PC is the first guide to be developed for primary care, co‐designed with patients, carers, general practitioners and pharmacists. The PSG‐PC will support patients and carers to partner with health‐care professionals to improve patient safety addressing international and national priorities to continuously improve patient safety.

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“…The PREOS-PC enables the comprehensive measurement of patient perceptions of safety in primary care and has been successfully used in the measurement and evaluation of patient safety in primary care in the United Kingdom 15–18 . For example, a set of questions on patients’ perceptions of practices engagement with safety asks “Thinking about the healthcare you have received in your GP surgery in the last 12 months, in general how often did you feel that your GP(s)…” with items included “Was (were) available when you needed to see or talk to them?” and “Explained your tests and treatments in a way you could understand?” with response options of “always,” “often,” “sometimes,” “rarely,” “never,” and “not applicable.” Qualitative research conducted as part of the evaluation of its implementation and use, however, suggests that its length (61 items across 5 domains) may limit its uptake in the routine evaluation of general practice 19 …”

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confidence: 99%

Development of 2 Short Patient-Report Questionnaires of Patient Safety in Primary Care

et al. 2021

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Objectives:The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) is a valid and reliable instrument (61 items across 5 domains) of patients' perceptions of safety. Stakeholder feedback has supported shorter versions for improving choice and facilitating uptake of routine patient-centered evaluation. We sought to develop 2 shorter versions of PREOS-PC: one including the shortest possible scales that met established measurement performance standards and a screening version including a single item per domain.Methods: A total of 1244 patients from 45 general practices across England completed PREOS-PC questionnaires. All scale items in PREOS-PC underwent Item Response Theory analysis, applying standard criteria for the item reduction. Cognitive debriefing from 10 patient interviews allowed for the assessment of the instruments' readability. The instruments' psychometrics properties were reassessed in a validation sample of 1557 patients in 21 English general practices.Results: "PREOS-PC Compact" includes 25 items and 2 open-ended questions across the 5 domains, 44% of the length of the original instrument. "PREOS-PC Screen" consists of 6 items: the best-performing single items for 2 domains, 1 item modified from original items for each of the remaining 3 domains, and 1 open-ended question. The evaluation of the instruments confirmed they were acceptable to patients and met standards for readability; construct, convergent, and divergent validity; and reliability.Conclusions: PREOS-PC Compact meets high-performance standards while reducing patient burden for routine monitoring of patient safety in primary care. PREOS-PC Screen is a concise tool apt for incorporation into audits and to target more in-depth review as needed.

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A Patient Safety Toolkit for Family Practices

Abstract: Supplemental digital content is available in the text.

Cited by 16 publications

References 26 publications

A comparative assessment of two tools designed to support patient safety culture in UK general practice

A comparative assessment of two tools designed to support patient safety culture in UK general practice

Developing a patient safety guide for primary care: A co‐design approach involving patients, carers and clinicians

Development of 2 Short Patient-Report Questionnaires of Patient Safety in Primary Care

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