scholarly journals Mixed methods evaluation of a computerised audit and feedback dashboard to improve patient safety through targeting acute kidney injury (AKI) in primary care

2021 ◽  
Vol 145 ◽  
pp. 104299
Author(s):  
Jung Yin Tsang ◽  
Benjamin Brown ◽  
Niels Peek ◽  
Stephen Campbell ◽  
Thomas Blakeman
Keyword(s):  
Primary Care ◽  
Acute Kidney Injury ◽  
Patient Safety ◽  
Mixed Methods ◽  
Improve Patient Safety ◽  
Kidney Injury ◽  
Audit And Feedback ◽  
Mixed Methods Evaluation ◽  
Improve Patient

scholarly journals Post-discharge care following acute kidney injury: quality improvement in primary care

2020 ◽  
Vol 9 (4) ◽  
pp. e000891
Author(s):  
Susan J Howard ◽  
Rebecca Elvey ◽  
Julius Ohrnberger ◽  
Alex J Turner ◽  
Laura Anselmi ◽  
...  
Keyword(s):  
Primary Care ◽  
Acute Kidney Injury ◽  
Patient Safety ◽  
Quality Improvement ◽  
Health Outcomes ◽  
Kidney Injury ◽  
Audit And Feedback ◽  
Improvement Project ◽  
General Practices ◽  
The Impact

BackgroundOver the past decade, targeting acute kidney injury (AKI) has become a priority to improve patient safety and health outcomes. Illness complicated by AKI is common and is associated with adverse outcomes including high rates of unplanned hospital readmission. Through national patient safety directives, NHS England has mandated the implementation of an AKI clinical decision support system in hospitals. In order to improve care following AKI, hospitals have also been incentivised to improve discharge summaries and general practices are recommended to establish registers of people who have had an episode of illness complicated by AKI. However, to date, there is limited evidence surrounding the development and impact of interventions following AKI.DesignWe conducted a quality improvement project in primary care aiming to improve the management of patients following an episode of hospital care complicated by AKI. All 31 general practices within a single NHS Clinical Commissioning Group were incentivised by a locally commissioned service to engage in audit and feedback, education training and to develop an action plan at each practice to improve management of AKI.ResultsAKI coding in general practice increased from 28% of cases in 2015/2016 to 50% in 2017/2018. Coding of AKI was associated with significant improvements in downstream patient management in terms of conducting a medication review within 1 month of hospital discharge, monitoring kidney function within 3 months and providing written information about AKI to patients. However, there was no effect on unplanned hospitalisation and mortality.ConclusionThe findings suggest that the quality improvement intervention successfully engaged a primary care workforce in AKI-related care, but that a higher intensity intervention is likely to be required to improve health outcomes. Development of a real-time audit tool is necessary to better understand and minimise the impact of the high mortality rate following AKI.

scholarly journals Adverse Drug Event Reporting From Clinical Care: Mixed-Methods Analysis for a Minimum Required Dataset (Preprint)

2018 ◽  
Author(s):  
David Peddie ◽  
Serena S Small ◽  
Katherin Badke ◽  
Chantelle Bailey ◽  
Ellen Balka ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Mixed Methods ◽  
Adverse Drug Event ◽  
Improve Patient Safety ◽  
Clinical Care ◽  
Drug Event ◽  
Care Providers ◽  
Event Reporting ◽  
Improve Patient

BACKGROUND Patients commonly transition between health care settings, requiring care providers to transfer medication utilization information. Yet, information sharing about adverse drug events (ADEs) remains nonstandardized. OBJECTIVE The objective of our study was to describe a minimum required dataset for clinicians to document and communicate ADEs to support clinical decision making and improve patient safety. METHODS We used mixed-methods analysis to design a minimum required dataset for ADE documentation and communication. First, we completed a systematic review of the existing ADE reporting systems. After synthesizing reporting concepts and data fields, we conducted fieldwork to inform the design of a preliminary reporting form. We presented this information to clinician end-user groups to establish a recommended dataset. Finally, we pilot-tested and refined the dataset in a paper-based format. RESULTS We evaluated a total of 1782 unique data fields identified in our systematic review that describe the reporter, patient, ADE, and suspect and concomitant drugs. Of these, clinicians requested that 26 data fields be integrated into the dataset. Avoiding the need to report information already available electronically, reliance on prospective rather than retrospective causality assessments, and omitting fields deemed irrelevant to clinical care were key considerations. CONCLUSIONS By attending to the information needs of clinicians, we developed a standardized dataset for adverse drug event reporting. This dataset can be used to support communication between care providers and integrated into electronic systems to improve patient safety. If anonymized, these standardized data may be used for enhanced pharmacovigilance and research activities.

scholarly journals Parents’ Active Role and ENgagement in The review of their Stillbirth/perinatal death 2 (PARENTS 2) study: a mixed-methods study of implementation

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044563
Author(s):  
Christy Burden ◽  
Danya Bakhbakhi ◽  
Alexander Edward Heazell ◽  
Mary Lynch ◽  
Laura Timlin ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Review Process ◽  
Parent Engagement ◽  
Improve Patient Safety ◽  
Parental Engagement ◽  
Mixed Methods Study ◽  
Bereaved Parents ◽  
The Uk ◽  
Improve Patient

ObjectiveWhen a formal review of care takes places after the death of a baby, parents are largely unaware it takes place and are often not meaningfully involved in the review process. Parent engagement in the process is likely to be essential for a successful review and to improve patient safety. This study aimed to evaluate an intervention process of parental engagement in perinatal mortality review (PNMR) and to identify barriers and facilitators to its implementation.DesignMixed-methods study of parents’ engagement in PNMR.SettingSingle tertiary maternity unit in the UK.ParticipantsBereaved parents and healthcare professionals (HCPs).InterventionsParent engagement in the PNMR (intervention) was based on principles derived through national consensus and qualitative research with parents, HCPs and stakeholders in the UK.OutcomesRecruitment rates, bereaved parents and HCPs’ perceptions.ResultsEighty-one per cent of bereaved parents approached (13/16) agreed to participate in the study. Two focus groups with bereaved parents (n=11) and HCP (n=7) were carried out postimplementation to investigate their perceptions of the process.Overarching findings were improved dialogue and continuity of care with parents, and improvements in the PNMR process and patient safety. Bereaved parents agreed that engagement in the PNMR process was invaluable and helped them in their grieving. HCP perceived that parent involvement improved the review process and lessons learnt from the deaths; information to understand the impact of aspects of care on the baby’s death were often only found in the parents’ recollections.ConclusionsParental engagement in the PNMR process is achievable and useful for parents and HCP alike, and critically can improve patient safety and future care for mothers and babies. To learn and prevent perinatal deaths effectively, all hospitals should give parents the option to engage with the review of their baby’s death.

scholarly journals Structural equation modeling for identification of patient safety antecedents in primary care

2020 ◽  
Author(s):  
Katarzyna Kosiek ◽  
Iwona Staniec ◽  
Maciej Godycki-Cwirko ◽  
Adam Depta ◽  
Anna Kowalczyk
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation Modeling ◽  
Structural Equation ◽  
Safety Management ◽  
Improve Patient Safety ◽  
Equation Modeling ◽  
Number Of Factors ◽  
Safety Interventions ◽  
Improve Patient

Abstract Background:. Patient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents. Methods: Medical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM). Results: SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres.Conclusions: The integrated safety model described in the study can improve patient safety management.

scholarly journals Adverse events analysis as an educational tool to improve patient safety culture in primary care: A randomized trial

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Clara González-Formoso ◽  
María Victoria Martín-Miguel ◽  
Ma José Fernández-Domínguez ◽  
Antonio Rial ◽  
Fernando Isidro Lago-Deibe ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Adverse Events ◽  
Randomized Trial ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Patient Safety Culture ◽  
Educational Tool ◽  
Improve Patient

scholarly journals Structural equation modeling for identification of patient safety antecedents in primary care

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katarzyna Kosiek ◽  
Iwona Staniec ◽  
Maciej Godycki-Cwirko ◽  
Adam Depta ◽  
Anna Kowalczyk
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation Modeling ◽  
Structural Equation ◽  
Safety Management ◽  
Improve Patient Safety ◽  
Equation Modeling ◽  
Number Of Factors ◽  
Safety Interventions ◽  
Improve Patient

Abstract Background Patient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents. Methods Medical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM). Results SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres. Conclusions The integrated safety model described in the study can improve patient safety management.

Piloting the SinergyAPS theory-based online intervention centred around the systematic patient feedback for improving patient safety in Primary Care: a mixed-methods feasibility study (Preprint)

2021 ◽  
Author(s):  
Maria J Serrano-Ripoll ◽  
Maria A. Fiol-DeRoque ◽  
José M. Valderas ◽  
Rocío Zamanillo-Campos ◽  
Joan Llobera ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Online Intervention ◽  
Patient Safety Culture ◽  
Post Intervention ◽  
Patient Feedback ◽  
Perceived Utility ◽  
Improve Patient

BACKGROUND Developing new strategies to support the provision of safer primary care (PC) is a major priority both internationally and in Spain, where around 3 million adverse events occur each year in the PC setting. OBJECTIVE The primary aims of this mixed-methods feasibility study were to examine the feasibility and to explore the acceptability and perceived utility of the SinergiAPS intervention, a novel low-cost and scalable theory-based online intervention to improve patient safety in PC centres, based on the use of patient feedback. The secondary aim was to examine the potential impact of the intervention to improve patient safety culture and avoidable hospitalizations in PC centres. METHODS We conducted a three-month, one-arm, feasibility trial in ten PC centres in Spain. Centres were fed back information regarding patients' experiences of safety (collected through PREOS-PC questionnaire) and were instructed to plan safety improvement actions based on it. We measured recruitment and follow-up rates, and intervention uptake (number of centres registering improvement plans). We explored the impact of the intervention on patient safety culture (MOSPSC questionnaire), and avoidable hospital admissions rate. We conducted semi-structured interviews with nine professionals to explore the acceptability and perceived utility of the intervention. RESULTS Of 256 professionals invited, 120 (47%) accepted to participate and 97 completed baseline and post-intervention measures. Of 780 patients invited, 585 (77%) completed the PREOS-PC questionnaire. Five centres designed 27 improvement actions. Most of the actions addressed treatment-related safety problems and consisted in the provision of training to PC providers. Compared to baseline, post-intervention MOSPSC scores were significantly higher (indicating a higher level of culture) for the safety culture synthetic index (3.36/5 at baseline vs. 3.44/5 at post-intervention (2% increase); p=0.01). No differences (p=0.11) were observed in avoidable admissions rate before (median (IQR)=0.78 (0.7 to 0.9) vs. after the intervention (0.45 (0.33 to 0.83)). The interviews revealed that the intervention was perceived as a novel strategy that could produce long-term safety improvements by raising their awareness and improving their technical knowledge about patient safety. CONCLUSIONS The proposed intervention is feasible to deliver and perceived as acceptable and useful by PC professionals if the barriers identified are addressed. The effectiveness of the refined intervention will be assessed in a trial involving 59 centres. CLINICALTRIAL clinicaltrials.gov NCT03837912

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