Teaching patient safety in global health: lessons from the Duke Global Health Patient Safety Fellowship

Johnston, Bria E; Lou‐Meda, Randall; Mendez, Sindy; Frush, Karen; Milne, J. Kenneth; Fitzgerald, Tamara N.; Rice, Henry E.

doi:10.1136/bmjgh-2018-001220

Cited by 18 publications

(13 citation statements)

References 35 publications

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“…This is surprising, as only 38.0% of participants had actually received patient safety training prior to this study and might be based on poor awareness and little knowledge of this subject rather than actual experience. Patient safety training has been shown to be effective for improvement of patient safety attitudes in various settings, including Palestine [11,13,[30][31][32][33][34][35]. Most of these studies monitored self-reported behaviour and attitudes.…”

Section: Discussionmentioning

confidence: 99%

Treating patients in a safe environment: a cross-sectional study of patient safety attitudes among doctors in the Gaza Strip, Palestine

Alfaqawi¹,

Böttcher²,

Abuowda

et al. 2020

BMC Health Serv Res

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Background Patient safety is important, as in increasingly complex medical systems, the potential for unintended harm to patients also increases. This study assessed the attitudes of doctors in the Gaza Strip towards patient safety and medical error. It also explored variables that impacted their attitudes. Methods Doctors, working for at least 6 months in one of the four major government hospitals of the Gaza Strip, were invited to complete a 28-item, self-administered Arabic version of the Attitudes to Patient Safety Questionnaire III (APSQ-III); which assessed patient safety attitudes over nine domains, independent of the workplace. Results A total of 150 doctors from four government hospitals participated in this study, representing 43.5% of all 345 doctors working in the four study hospitals at the time of the study. The mean age was 36.6 (±9.7) years. The majority (72.7%) were males, 28.7% worked in surgical, 26.7% in pediatric, 23.3% in medical, 16.7% in obstetrics and gynecology, and 4.7% in other departments. Most participants (62.0%) had never received patient safety training. The overall APSQ score was 3.58 ± 0.3 (of a maximum of 5). The highest score was received by the domain “Working hours as a cause of errors” (4.16) and the lowest score by “Importance of Patient Safety in the Curriculum” (3.25). Older doctors with more professional experience had significantly higher scores than younger doctors (p = 0.003), demonstrating more positive attitudes toward patient safety. Furthermore, patient safety attitudes became more positive with increasing years of experience in some domains. However, no significant impact on overall APSQ scores was found by workplace, specialty or whether the participants had received previous training about patient safety. Conclusion Doctors in Gaza demonstrated relatively positive patient safety attitudes in areas of “team functioning” and “working hours as a cause for error”, but neutral attitudes in understanding medical error or patient safety training within the curriculum. Patient safety concepts appear to be acquired by doctors via informal learning over time in the job. Inclusion of such concepts into formal postgraduate curricula might improve patient safety attitudes among younger and less experienced doctors, support behaviour change and improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Treating patients in a safe environment: a cross-sectional study of patient safety attitudes among doctors in the Gaza Strip, Palestine

Alfaqawi¹,

Böttcher²,

Abuowda

et al. 2020

BMC Health Serv Res

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“…These initiatives include "global patient safety challenges" focusing on medications (6), clean care and safe surgical practices; strengthening knowledge transfer and technical capacity; empowering patients and families to serve as safety advocates; a health care professions curriculum guide; developing organizational leadership capacity; technical training for primary care settings; measuring, collecting, and analyzing data on patient safety incidents; and monitoring the efficacy of health care system improvements (2). In the context of challenges faced by developing countries, Johnston et al report on a fellowship to prepare physicians to lead interdisciplinary patient safety initiatives in resource-limited health care environments (7), while Elmonstri et al propose a holistic, integrated, patient-centered approach to improving patient safety that engages political leaders and stakeholders, empowers regulatory bodies, promotes a culture of safety, supports research and technology infrastructures, and prioritizes patient safety in health care education (8).…”

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confidence: 99%

Distance learning and patient safety: Report and evaluation of an online patient safety course

Ortega

Cometto

Grajales

et al. 2020

Revista Panamericana De Salud Pública

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Patient safety is a critical topic in health care globally, with implications for nurses, physicians, administrators, and most importantly, patients and their well-being. Online distance learning (ODL) is widely accepted among most disciplines in higher education and has been used to promote patient safety knowledge among health care students and professionals in diverse contexts. This article reports on an online Nursing and Patient Safety course developed in 2012 by the University of Miami School of Nursing and Health Studies in conjunction with the Pan American Health Organization and the International Network for Nursing and Patient Safety. The study’s objectives are to describe the implementation of an international ODL program to enhance patient safety knowledge in nurses and nursing students, and to examine the participants’ assessments of this online approach as an effective learning tool. Most participants who completed the Nursing and Patient Safety ODL course reported being satisfied with the course content and experience, and demonstrated increased knowledge on patient safety, as measured by post-module quizzes and self-report. Limitations of the study include the lack of a comparison group, disparity in the number of participants across the course’s language formats (English, Portuguese, Spanish), and the large number of participants who registered for but did not complete the course. Future research should identify obstacles to course completion, explore participants’ awareness of patient safety issues and perceived need for more instruction, and look at ways to disseminate the course to the broadest international population of nurses and nursing students.

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“…13 Interviews were used to evaluate staff perceptions towards patient safety, as well as barriers and facilitators to programme implementation. Although the SSIs explored all CFIR domains, the interview guide prioritised CFIR constructs based on our prior stakeholder analysis 11 21…”

Section: Methodsmentioning

confidence: 99%

Implementation challenges to patient safety in Guatemala: a mixed methods evaluation

et al. 2021

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BackgroundLittle is known about factors affecting implementation of patient safety programmes in low and middle-income countries. The goal of our study was to evaluate the implementation of a patient safety programme for paediatric care in Guatemala.MethodsWe used a mixed methods design to examine the implementation of a patient safety programme across 11 paediatric units at the Roosevelt Hospital in Guatemala. The safety programme included: (1) tools to measure and foster safety culture, (2) education of patient safety, (3) local leadership engagement, (4) safety event reporting systems, and (5) quality improvement interventions. Key informant staff (n=82) participated in qualitative interviews and quantitative surveys to identify implementation challenges early during programme deployment from May to July 2018, with follow-up focus group discussions in two units 1 year later to identify opportunities for programme modification. Data were analysed using thematic analysis, and integrated using triangulation, complementarity and expansion to identify emerging themes using the Consolidated Framework for Implementation Research. Salience levels were reported according to coding frequency, with valence levels measured to characterise the degree to which each construct impacted implementation.ResultsWe found several facilitators to safety programme implementation, including high staff receptivity, orientation towards patient-centredness and a desire for protocols. Key barriers included competing clinical demands, lack of knowledge about patient safety, limited governance, human factors and poor organisational incentives. Modifications included use of tools for staff recognition, integration of education into error reporting mechanisms and designation of trained champions to lead unit-based safety interventions.ConclusionImplementation of safety programmes in low-resource settings requires recognition of facilitators such as staff receptivity and patient-centredness as well as barriers such as lack of training in patient safety and poor organisational incentives. Embedding an implementation analysis during programme deployment allows for programme modification to enhance successful implementation.

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Teaching patient safety in global health: lessons from the Duke Global Health Patient Safety Fellowship

Cited by 18 publications

References 35 publications

Treating patients in a safe environment: a cross-sectional study of patient safety attitudes among doctors in the Gaza Strip, Palestine

Treating patients in a safe environment: a cross-sectional study of patient safety attitudes among doctors in the Gaza Strip, Palestine

Distance learning and patient safety: Report and evaluation of an online patient safety course

Implementation challenges to patient safety in Guatemala: a mixed methods evaluation

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