Terminal care: improving teamwork in primary care using Significant Event Analysis

Abstract

Significant Event Analysis can be used to improve the effectiveness of a Primary Health Care Team caring for terminally ill patients. A method of doing this is described in detail. Positive team qualities were confirmed and enhanced. Significant areas for improvement were identified: insufficient information had been given to some key workers, changes in medication had been poorly planned, continuity of care, and emotional and professional support of team members were inadequate. A strategy for change was developed and implemented. Performance was reviewed a year later. It was found that the Significant Event Analysis had caused changes in team practices, and was valid and reliable enough to be used as a tool for improving teamwork in primary care in future.

Interventions to improve team effectiveness: A systematic review

“…These checklists had to be completed by the teams at a given moment. Two ways of analysing cases to gather themes for improvement are significant event analysis and critical case reviews [47,48]. The target group of most studies was multidisciplinary teams in acute (hospital) care.…”

A qualitative study of why general practitioners may participate in significant event analysis and educational peer assessment

“…13 The technique is also perceived as a means of facilitating immediate team learning and needs assessment, which have been confirmed or proposed in previous studies. 2 [23][24][25] An unexpected finding was that analysing and writing up an event may act as a form of personal catharsis.…”

Awareness and analysis of a significant event by general practitioners: a cross sectional survey

“…15 16 Both were concerned with the quality of SEA reports and the factors involved in gaining a successful peer assessment. Further work has shown SEA to be a useful tool for reflective practice, 17 improving teamwork in primary health care, 18 involving patients in assessing the quality of their care, 19 and in developing clinical governance in the prison healthcare service. 20 The relevance of addressing significant events and the ability to apply the SEA technique has been brought into sharp focus as a professional issue for all GPs with the impending system of appraisal and revalidation for all UK doctors.…”