scholarly journals Nature and type of patient-reported safety incidents in primary care: cross-sectional survey of patients from Australia and England

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042551
Author(s):  
Andrea L Hernan ◽  
Sally J Giles ◽  
Andrew Carson-Stevens ◽  
Mark Morgan ◽  
Penny Lewis ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Patient ◽  
Care Patient ◽  
System Level ◽  
Service Improvement ◽  
Cross Sectional ◽  
Positive Effects ◽  
Contributory Factors ◽  
Safety Incident ◽  
Patient Reported

BackgroundPatient engagement in safety has shown positive effects in preventing or reducing adverse events and potential safety risks. Capturing and utilising patient-reported safety incident data can be used for service learning and improvement.ObjectiveThe aim of this study was to characterise the nature of patient-reported safety incidents in primary care.DesignSecondary analysis of two cross sectional studies.ParticipantsAdult patients from Australian and English primary care settings.MeasuresPatients’ self-reported experiences of safety incidents were captured using the validated Primary Care Patient Measure of Safety questionnaire. Qualitative responses to survey items were analysed and categorised using the Primary Care Patient Safety Classification System. The frequency and type of safety incidents, contributory factors, and patient and system level outcomes are presented.ResultsA total of 1329 patients (n=490, England; n=839, Australia) completed the questionnaire. Overall, 5.3% (n=69) of patients reported a safety incident over the preceding 12 months. The most common incident types were administration incidents (n=27, 31%) (mainly delays in accessing a physician) and incidents involving diagnosis and assessment (n=16, 18.4%). Organisation of care accounted for 27.6% (n=29) of the contributory factors identified in the safety incidents. Staff factors (n=13, 12.4%) was the second most commonly reported contributory factor. Where an outcome could be determined, patient inconvenience (n=24, 28.6%) and clinical harm (n=21, 25%) (psychological distress and unpleasant experience) were the most frequent.ConclusionsThe nature and outcomes of patient-reported incidents differ markedly from those identified in studies of staff-reported incidents. The findings from this study emphasise the importance of capturing patient-reported safety incidents in the primary care setting. The patient perspective can complement existing sources of safety intelligence with the potential for service improvement.

scholarly journals The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5656
Author(s):  
Krzysztof Studziński ◽  
Tomasz Tomasik ◽  
Adam Windak ◽  
Maciej Banach ◽  
Ewa Wójtowicz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Primary Care Physicians ◽  
Primary Care Patient ◽  
Care Patient ◽  
Cross Sectional ◽  
Therapeutic Goals ◽  
Rural Primary Care

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.

scholarly journals Exploring the Relationship Between Serum Magnesium, Inflammation, and Chronic Pain in a Vermont Primary Care Population

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1821-1821
Author(s):  
Benjamin Littenberg ◽  
Thomas Ahern ◽  
Emily Tarleton
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Medical Center ◽  
Primary Care Patient ◽  
Serum Magnesium ◽  
Random Noise ◽  
Univariate Analysis ◽  
Care Patient ◽  
Cross Sectional ◽  
The Relationship

Abstract Objectives We sought to describe the relationship between serum magnesium, inflammation, and chronic pain in adult primary care patient. Methods We sought to describe this relationship utilizing a cross-sectional analysis of medical records from 5639 adults (mean age 59 years; 42% men) seen in The University of Vermont Medical Center primary care clinics between 2015 and 2018. Patients with at least one serum magnesium level, C-reactive protein (CRP, a measure of inflammation) level, and chronic pain score (self-reported visual analogue scale) were included. Results Univariate analysis confirmed the relationship between serum magnesium and chronic pain (−0.31 points/mg/dL; 95% CI −0.47, −0.14; P &lt; 0.001). However, when serum magnesium and CRP were both included in the model, the relationship with pain is unclear (N = 1345; CI −0.003, 0.002; P = 0.69). Conclusions For adults seen in primary care, lower serum magnesium levels are associated with chronic pain. This inverse relationship is not explained by random noise, including age and gender. The complex relationship between serum magnesium, CRP, and pain is complex requires further exploration. Funding Sources None.

scholarly journals Effectiveness of New Tools to Define an Up-to-Date Patient Safety Risk Map: A Primary Care Study Protocol

2021 ◽  
Vol 18 (16) ◽  
pp. 8612
Author(s):  
Montserrat Gens-Barberà ◽  
Cristina Rey-Reñones ◽  
Núria Hernández-Vidal ◽  
Elisa Vidal-Esteve ◽  
Yolanda Mengíbar-García ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Improve Patient Safety ◽  
Primary Care Patient ◽  
Phase 1 ◽  
Care Patient ◽  
Risk Map ◽  
Improvement Strategy ◽  
Cross Sectional ◽  
Safety Risk

Background: Reducing incidents related to health care interventions to improve patient safety is a health policy priority. To strengthen a culture of safety, reporting incidents is essential. This study aims to define a patient safety risk map using the description and analysis of incidents within a primary care region with a prior patient safety improvement strategy organisationally developed and promoted. Methods: The study will be conducted in two phases: (1) a cross-sectional descriptive observational study to describe reported incidents; and (2) a quasi-experimental study to compare reported incidents. The study will take place in the Camp de Tarragona Primary Care Management (Catalan Institute of Health). In Phase 1, all reactive notifications collected within one year (2018) will be analysed; during Phase 2, all proactive notifications of the second and third weeks of June 2019 will be analysed. Adverse events will also be assessed. Phases 1 and 2 will use a digital platform and the proactive tool proSP to notify and analyse incidents related to patient safety. Expected Results: To obtain an up-to-date, primary care patient safety risk map to prioritise strategies that result in safer practices.

EXPECTATION OF CLIENTS TOWARDS PRIMARY CARE SERVICE AT COMMUNE HEALTH CENTERS

2017 ◽  
pp. 70-77
Author(s):  
Thi Hoa Nguyen ◽  
Thi Thao Nguyen ◽  
Minh Tam Nguyen
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Primary Care Patient ◽  
Care Service ◽  
Care Patient ◽  
Care Quality ◽  
Health Centers ◽  
Primary Care Service ◽  
Cross Sectional ◽  
Care Services

Background: Patients’ expectations are considered to influence their satisfaction with the service provided. This can be used to provide a deeper understanding and better approach to improve health care delivery. Objectives: This study was to identify patients' expectations forhealth care services at commune health centers in Huong Thuy Town, Thua Thien Hue province. Methods: A cross-sectional study with data collected from 423 people in Huong Thuy, using the 38-item standardized questionnaire to measure patients' expectations of primary care. A five score Likert scale from strongly disagree to strongly agree was used to report people’s expectation towards primary care services at commune health centers. Results: Among five important features of primary care, patient expectations for aspects of the medical care were the highest ranking. Aspects that achieved the lowest expectations were the availability and accessibility. The items such as “Facilities should be well equipped and modern”, “Doctor should guide patient in taking medicines correctly” and “Doctor should make patient feel free and comformtable to talk about health issues” received the highest scores. Conclusions: The study provides evidence on what patients expect for primary care service, thus helps to improve primary care quality, especially on the aspects that patients rate highest priorities. Key words: primary care, patient’s expectation, commune health center

scholarly journals Automated classification of primary care patient safety incident report content and severity using supervised machine learning (ML) approaches

2019 ◽  
Vol 26 (4) ◽  
pp. 3123-3139 ◽  
Author(s):  
Huw Prosser Evans ◽  
Athanasios Anastasiou ◽  
Adrian Edwards ◽  
Peter Hibbert ◽  
Meredith Makeham ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Care Patient ◽  
Free Text ◽  
Incident Report ◽  
Incident Type ◽  
Safety Incident ◽  
Patient Safety Incident ◽  
Incident Reports

Learning from patient safety incident reports is a vital part of improving healthcare. However, the volume of reports and their largely free-text nature poses a major analytic challenge. The objective of this study was to test the capability of autonomous classifying of free text within patient safety incident reports to determine incident type and the severity of harm outcome. Primary care patient safety incident reports (n=31333) previously expert-categorised by clinicians (training data) were processed using J48, SVM and Naïve Bayes. The SVM classifier was the highest scoring classifier for incident type (AUROC, 0.891) and severity of harm (AUROC, 0.708). Incident reports containing deaths were most easily classified, correctly identifying 72.82% of reports. In conclusion, supervised ML can be used to classify patient safety incident report categories. The severity classifier, whilst not accurate enough to replace manual processing, could provide a valuable screening tool for this critical aspect of patient safety.

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

2021 ◽  
Vol 10 (8) ◽  
pp. 1782
Author(s):  
Ignacio Ricci-Cabello ◽  
Aina María Yañez-Juan ◽  
Maria A. Fiol-deRoque ◽  
Alfonso Leiva ◽  
Joan Llobera Canaves ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Cross Sectional ◽  
Morbidity Burden ◽  
Patient Reported ◽  
Patient Complexity ◽  
Complex Relationships ◽  
The Impact

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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