Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach

Ricci‐Cabello, Ignacio; Reeves, David; Bell, Brian; Valderas, José M

doi:10.1136/bmjqs-2016-006411

Cited by 16 publications

(15 citation statements)

References 38 publications

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“…Many of the questions from these domains were not concerned with contributory factors to safety incidents but rather outcomes of safety incidents (eg, ‘the diagnosis or treatment plan recommended by my doctor, nurse or other health professional was right for me’) or actions patients took to prevent safety incidents (eg, ‘I feel I cannot speak up about certain things with health professionals at the practice’ (negatively worded)). These items need to be considered further about their potential value and use in primary care practice 52…”

Section: Discussionmentioning

confidence: 99%

Validation of the Primary Care Patient Measure of Safety (PC PMOS) questionnaire

2018

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BackgroundThe Primary Care Patient Measure of Safety (PC PMOS) is designed to capture patient feedback about the contributing factors to patient safety incidents in primary care. It required further reliability and validity testing to produce a robust tool intended to improve safety in practice.Method490 adult patients in nine primary care practices in Greater Manchester, UK, completed the PC PMOS. Practice staff (n = 81) completed a survey on patient safety culture to assess convergent validity. Confirmatory factor analysis (CFA) assessed the construct validity and internal reliability of the PC PMOS domains and items. A multivariate analysis of variance was conducted to assess discriminant validity, and Spearman correlation was conducted to establish test–retest reliability.ResultsInitial CFA results showed data did not fit the model well (a chi-square to df ratio (CMIN/DF) = 5.68; goodness-of-fit index (GFI) = 0.61, CFI = 0.57, SRMR = 0.13 and root mean square error of approximation (RMSEA) = 0.10). On the basis of large modification indices (>10), standardised residuals >± 2.58 and assessment of item content; 22 items were removed. This revised nine-factor model (28 items) was found to fit the data satisfactorily (CMIN/DF = 2.51; GFI = 0.87, CFI = 0.91, SRMR = 0.04 and RMSEA = 0.05). New factors demonstrated good internal reliability with average inter-item correlations ranging from 0.20 to 0.70. The PC PMOS demonstrated good discriminant validity between primary care practices (F = 2.64, df = 72, p < 0.001) and showed some association with practice staff safety score (convergent validity) but failed to reach statistical significance (r = −0.64, k = 9, p = 0.06).ConclusionThis study led to a reliable and valid 28-item PC PMOS. It could enhance or complement current data collection methods used in primary care to identify and prevent error.

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Section: Discussionmentioning

confidence: 99%

Validation of the Primary Care Patient Measure of Safety (PC PMOS) questionnaire

2018

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“…A previous study with 1190 patients registered in 45 practices did not show any association between multimorbidity and polypharmacy and selected PREOS-PC scores in a regression model with patient and practice activation as independent variables and adjusted for a range of clinical and sociodemographic characteristics, but not gender, as it was not statistically significantly associated with the dependent variables in bivariate analyses [43].…”

Section: Discussion Of Main Findings and Comparison With The Previous Literaturementioning

confidence: 64%

Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data

Ricci‐Cabello

Yañez

Fiol-deRoque

et al. 2021

JCM

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We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men.

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“…Las principales fortalezas del estudio son el uso de un cuestionario validado y fiable 13 , 16 , el elevado tamaño muestral y el uso de estimadores robustos para evaluar la SP en AP 17 . Además, el uso de métodos mixtos permite ofrecer una mayor comprensión del objeto de estudio, reforzando y ampliando los resultados obtenidos en el análisis cuantitativo 18 .…”

Section: Discussionunclassified

Impacto de la pandemia de COVID-19 en la seguridad del paciente percibida por los pacientes en Atención Primaria

et al. 2021

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Objetivo Evaluar el impacto de los cambios introducidos en respuesta a la pandemia sobre la seguridad del paciente (SP) percibida por los pacientes en Atención Primaria. Diseño Estudio observacional prospectivo de panel (centro de salud [CS]) basado en dos encuestas transversales. Emplazamiento 29 CS de tres regiones sanitarias de España (Mallorca, Cataluña Central y Camp de Tarragona). Participantes Muestreo aleatorio de pacientes que consultaron los CS antes (n = 2.199) y durante (n = 1.955) la pandemia. Mediciones principales Se administró el cuestionario validado PREOS-PC, que evalúa la SP experimentada por los pacientes atendidos en Atención Primaria. Se compararon las puntuaciones medias en las escalas «experiencias de errores» y «daño» en ambos períodos y se realizaron análisis de regresión multinivel para estudiar las variaciones en las características de los pacientes y de los CS asociadas a la percepción de peores niveles de seguridad. Se realizó un análisis cualitativo de contenido sobre las experiencias de los pacientes durante la pandemia. Resultados Las puntuaciones de «errores» y «daño» empeoraron significativamente durante el período de COVID-19 (92,65 a 88,81 [d de Cohen = 0,27]; y 96,92 a 79,97 [d = 0,70], respectivamente). Se observó un mayor empeoramiento en mujeres, personas con menor nivel educativo, peor estado de salud y con más años adscritos al centro. También se observaron diferencias en función de la región sanitaria. Conclusiones Durante la pandemia ha empeorado la SP percibida por los pacientes atendidos en Atención Primaria, siendo el impacto desigual según las características sociodemográficas de los pacientes y el perfil de los centros de salud.

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Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach

Cited by 16 publications

References 38 publications

Validation of the Primary Care Patient Measure of Safety (PC PMOS) questionnaire

Validation of the Primary Care Patient Measure of Safety (PC PMOS) questionnaire

Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data

Impacto de la pandemia de COVID-19 en la seguridad del paciente percibida por los pacientes en Atención Primaria

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