How do chiropractors manage clinical risk? A questionnaire study

Wangler, Martin; Peterson, Cynthia; Zaugg, Beatrice; Thiel, Haymo; Finch, Robert A.

doi:10.1186/2045-709x-21-18

Cited by 5 publications

(3 citation statements)

References 6 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Experience emerging from a number of European chiropractic incident reporting and learning initiatives both aligns with our findings and describes efforts to move beyond the familiar impediments of under-reporting, non-recognition of reportable events, fear of recrimination and time burden to practitioners [ 46 – 50 ]. Currently underway, the Canadian SafetyNET initiative, incorporates multi-phased strategies involving stakeholders from a range of professions to identify challenges and opportunities in promoting patient safety, assessing safety culture and developing and implementing specific incident reporting and education protocols [ 25 ].…”

Section: Discussionsupporting

confidence: 61%

Exploring approaches to patient safety: the case of spinal manipulation therapy

Rozmovits¹,

Mior

Boon

2016

BMC Complement Altern Med

View full text Add to dashboard Cite

BackgroundThe purpose of this study was to gain insight into the current safety culture around the use of spinal manipulation therapy (SMT) by regulated health professionals in Canada and to explore perceptions of readiness for implementing formal mechanisms for tracking associated adverse events.MethodsFifty-six semi-structured telephone interviews were conducted with professional leaders and frontline practitioners in chiropractic, physiotherapy, naturopathy and medicine, all professions regulated to perform SMT in the provinces of Alberta and Ontario Canada. Interviews were digitally audio-recorded for verbatim transcription. Transcripts were entered into HyperResearch software for qualitative data analysis and were coded for both anticipated and emergent themes using the constant comparative method. A thematic, descriptive analysis was produced.ResultsThe safety culture around SMT is characterized by substantial disagreement about its actual rather than putative risks. Competing intra- and inter-professional narratives further cloud the safety picture. Participants felt that safety talk is sometimes conflated with competition for business in the context of fee-for-service healthcare delivery by several professions with overlapping scopes of practice. Both professional leaders and frontline practitioners perceived multiple barriers to the implementation of an incident reporting system for SMT.ConclusionsThe established ‘measure and manage’ approach to patient safety is difficult to apply to care which is geographically dispersed and delivered by practitioners in multiple professions with overlapping scopes of practice, primarily in a fee-for-service model. Collaboration across professions on models that allow practitioners to share information anonymously and help practitioners learn from the reported incidents is needed.

show abstract

Section: Discussionsupporting

confidence: 61%

Exploring approaches to patient safety: the case of spinal manipulation therapy

Rozmovits¹,

Mior

Boon

2016

BMC Complement Altern Med

View full text Add to dashboard Cite

show abstract

“…Whilst a positive attitude towards patient safety has been observed within the chiropractic profession, SI reporting remains an unlikely course of action [ 24 ]. A lack of engagement with SI reporting is common across healthcare [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Ten years of online incident reporting and learning using CPiRLS: implications for improved patient safety

Thomas

Swait²,

Finch³

2023

Chiropr Man Therap

Self Cite

View full text Add to dashboard Cite

Background Safety incident (SI) reporting and learning via incident reporting systems (IRSs) is used to identify areas for patient safety improvement. The chiropractic patient incident reporting and learning system (CPiRLS) is an online IRS that was launched in the UK in 2009 and, from time to time, has been licensed for use by the national members of the European Chiropractors' Union (ECU), members of Chiropractic Australia and a Canada-based research group. The primary aim of this project was to analyse the SIs submitted to CPiRLS over a 10-year period to identify key areas for patient safety improvement. Method All SIs reported to CPiRLS between April 2009 and March 2019 were extracted and analysed. Descriptive statistics were used to describe: (1) the frequency of SI reporting and learning by the chiropractic profession, and (2) the character of reported SIs. Key areas for patient safety improvement were developed following a mixed methods approach. Results A total of 268 SIs were recorded on the database over the 10-year period, 85% of which originated from the UK. Evidence of learning was documented in 143 (53.4%) SIs. The largest subcategory of SIs related to post-treatment distress or pain (n = 71, 26.5%). Seven key areas for patient improvement were developed including: (1) patient trip/fall, (2) post treatment distress/pain, (3) negative effects during treatment, (4) significant post-treatment effects, (5) syncope, (6) failure to recognize serious pathology, and (7) continuity of care. Conclusion The low number of SIs reported over a 10-year period suggests significant under-reporting, however, an upward trend was identified over the 10-year period. Several key areas for patient safety improvement have been identified for dissemination to the chiropractic profession. Improved reporting practice needs to be facilitated to improve the value and validity of reporting data. CPiRLS is important in identifying key areas for patient safety improvement.

show abstract

“…Whilst a positive attitude towards patient safety has been observed within the chiropractic profession, SI reporting is an unlikely course of action [21]. A lack of engagement with SI reporting is common across healthcare [22,23].…”

Section: Discussionmentioning

confidence: 99%

Ten years of online incident reporting and learning using CPiRLS: implications for improved patient safety.

Thomas

Swait²,

Finch³

2022

Preprint

Self Cite

View full text Add to dashboard Cite

Background Safety Incident (SI) reporting and learning via incident reporting systems (IRS) is used to identify areas for patient safety improvement. The Chiropractic Patient Incident Reporting and Learning System (CPiRLS) was launched in 2009 and is currently available to all UK chiropractors and members of the European Chiropractors Union (ECU). The primary aim was to analyse the SIs submitted to CPiRLS over a 10-year period to identify key areas for patient safety improvement. Method All SIs on CPiRLS were extracted and analysed over a 10-year period (April 2009 to March 2019). Frequency statistics were used to describe 1) the level of SI reporting and learning by the chiropractic profession 2) the nature of the reported SIs including levels of patient harm. Key areas for patient safety improvement were identified following review of the database and consideration by an expert panel. Results A total of 268 SIs were recorded on the database over the 10-year period, of those, 85% originated from the UK. Evidence of learning was documented in 143 (53.4%) SIs. The largest subcategory of SIs related to post-treatment distress or pain, n = 71 (26.5%). Twenty-nine (10.8%) of all SIs involved a (potential) trip or fall with an additional eight SIs relating to syncope. A total of 26 (9.7%) SIs represented some type of rib distress or pain with 14 suggesting a rib fracture was likely to have occurred. Twenty-two (8.2%) SIs related to (potentially) missing a potential serious underlying pathology. Fourteen (5.2%) SIs involved disruption in the continuity of care. Six key areas of patient safety improvement were identified following review of the data and consideration of the expert panel. Conclusion Under-reporting of SIs is apparent on CPiRLS, however, an upward trend was identified over the 10-year period. Several key areas for patient safety improvement have been identified that need to be disseminated to the chiropractic profession including through the development of safer practice notices. Improved reporting practice needs to be facilitated to improve the value and validity of reporting data. CPiRLS is important in identifying key areas for patient safety improvement and should be reviewed periodically.

show abstract

How do chiropractors manage clinical risk? A questionnaire study

Cited by 5 publications

References 6 publications

Exploring approaches to patient safety: the case of spinal manipulation therapy

Exploring approaches to patient safety: the case of spinal manipulation therapy

Ten years of online incident reporting and learning using CPiRLS: implications for improved patient safety

Ten years of online incident reporting and learning using CPiRLS: implications for improved patient safety.

Contact Info

Product

Resources

About