Monitoring patient safety in primary care: an exploratory study using in-depth semistructured interviews

Abstract

ObjectivesTo explore how information and data are used to monitor patient safety and quality of primary care by professionals working in, or supporting, primary healthcare.DesignQualitative study of semistructured interviews with a directed content analysis of transcripts.SettingNorth-West London, UK.Participants21 individuals from various levels of the primary healthcare system were recruited, including general practitioners, practice nurses, practice managers, members of Clinical Commissioning Group (CCG) governing bodies, and senior members of regional patient safety teams.ResultsParticipants described being overwhelmed with complicated data which lacked any meaningful analyses about safety and quality. There was also a lack of clarity over which patient safety events are expected to be reported or monitored. Participants also reported uncertainty on whose responsibility it was to act on patient safety information or concerns. At the practice level, there was a range of disincentives for responding to and acting on safety issues and concerns, with few reported benefits. Participants made recommendations to improve future monitoring.ConclusionsThere is a need for clearer information in the form of specific guidelines, policies and procedures with regard to who monitors patient safety in primary care, what is monitored and how it should be monitored.

Systems levers for commissioning primary mental healthcare: a rapid review

“…Successful use of data to inform commissioning is dependent in equal measures on technical skill and stakeholder support of data collection activities (Perera et al 2013;Ashton 2015;Samra et al 2015;Ball et al 2016); poorly selected performance indicators run the risk of negatively affecting performance (Jacobs et al 2006). Tremendous effort has been expended in Australia to establish high-quality routine data collection of mental healthcare processes and outcomes, as well as to develop the mental health research workforce (Bywood et al 2015).…”

“…Thus, it may be used to enhance the costeffectiveness of commissioning and equity (Chan et al 2010;Breton et al 2011;Perera et al 2013;Bywood et al 2015;Salway et al 2016); it is also a key part of performance measurement, management and improvement, and clinical governance (Phillips et al 2010;Bassilios et al 2013;Bywood et al 2015;Ham et al 2015). Effective use of this lever is undermined by time pressures, duplication of effort, unclear or excessive data collection or reporting requirements and poorly aligned indicators (Phillips et al 2010;Perera et al 2013;Ham et al 2015;Samra et al 2015).…”

“…Providing meaningful feedback to clinicians regarding their performance, and publicising performance indicators are an important part of fostering trust in the system and ensuring stakeholder buy-in (Samra et al 2015;Ball et al 2016). However, there is a risk that negative feedback may result in disengagement (Ball et al 2016).…”

“…Organisation. Clear delineation of roles and responsibilities for reporting is necessary (Samra et al 2015). Finance and payment.…”

The safety climate in primary care (SAP-C) study: study protocol for a randomised controlled feasibility study

“…The outcomes of patient safety incidents vary; research suggests that 50 % have no ill consequences, 20 % result in delays in diagnoses, 10 % result in patient distress, and 20 % have serious consequences for the patient’s health [19]. British primary care physicians have noted a number of impediments to monitoring patient safety in their workplaces including a lack of access to pertinent data or uncertainty regarding the metrics of patient safety that should be monitored, a lack of clarity regarding policies and procedures for assessing patient safety and addressing incidents of harm, and a lack of clarity surrounding whose responsibility is the monitoring of patient care [20]. …”