scholarly journals Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

2020 ◽  
Author(s):  
Ian J Litchfield ◽  
Rachel Spencer ◽  
Brian Bell ◽  
Anthony Avery ◽  
Katherine Perryman ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Safety Information ◽  
Care Patient ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Practice Staff ◽  
Safety Issues

Abstract Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful. Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.

scholarly journals Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

2020 ◽  
Author(s):  
Ian J Litchfield ◽  
Rachel Spencer ◽  
Brian Bell ◽  
Anthony Avery ◽  
Katherine Perryman ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Safety Information ◽  
Care Patient ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Practice Staff ◽  
Safety Issues

Abstract Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful. Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.

scholarly journals Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

2020 ◽  
Author(s):  
Ian J Litchfield ◽  
Rachel Spencer ◽  
Brian Bell ◽  
Anthony Avery ◽  
Katherine Perryman ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Safety Information ◽  
Care Patient ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Practice Staff ◽  
Safety Issues

Abstract Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful. Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.

scholarly journals Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

2019 ◽  
Author(s):  
Ian J Litchfield ◽  
Rachel Spencer ◽  
Brian Bell ◽  
Anthony Avery ◽  
Katherine Perryman ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Safety ◽  
Primary Care Patient ◽  
Safety Information ◽  
Care Patient ◽  
Structured Interviews ◽  
Safety Issues ◽  
It Systems ◽  
Item Checklist ◽  
Qualitative Exploration

Abstract Background We identified a need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. The process of development is described from initial expert consensus of a long list of items suitable for inclusion on the checklist through their refinement following staff feedback to the nine items included on the prototype checklist. We then present the results of the pilot of the prototype checklist and a qualitative exploration of staff attitudes to its utility and usability. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the resulting statements summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing and use of IT systems. A 13 item checklist was trialled in 16 practices resulting in a 9 item prototype tool, which was tested in 8 practices. Qualitative data on the utility and usability of the prototype checklist was collected with a series of semi-structured interviews. Results In testing the prototype 4 of 9 items on the checklist were achieved 100% of the time, 3 items 87% of the time and 2 items 75% of the time. Participants expressed concern about the utility and implementation of checklists in general. However, the prototype was praised for its brevity and its use as a learning tool and ‘final check’ on elements of safety that the practices considered important. Conclusions The concise patient safety checklist tool, specifically designed for general practice, has been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Practice managers/GP partners should find it a useful tool to monitor safety within the practice.

scholarly journals Validation of the Primary Care Patient Measure of Safety (PC PMOS) questionnaire

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697157
Author(s):  
Sally J Giles ◽  
Sahdia Parveen ◽  
Andrea Hernan
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Primary Care Patient ◽  
Statistical Significance ◽  
Patient Safety Culture ◽  
Care Patient ◽  
Internal Reliability ◽  
Practice Staff

BackgroundThe Primary Care Patient Measure of Safety (PC PMOS) questionnaire was developed to collect patient feedback on 15 latent conditions in the primary care environment that influence safety incidents. It provides a way for primary care organisations to learn about safety from the patient perspective, and to then make service improvements with the aim of reducing harm in this setting.AimTo undertake validation testing PC PMOS questionnaire.Method490 adult patients from nine general practices completed the PC PMOS, and 81 practice staff completed the AHRQ medical office survey on patient safety culture. Confirmatory factor analysis (CFA) was undertaken to assess the reliability and validity of the 10 factor PC PMOS.ResultsCFA demonstrated data did not fit the model well (CMIN/DF = 5.68; GFI = 0.61, CFI = 0.57, SRMR = 0.13 and RMSEA = 0.10), thus post hoc model fitting was conducted. This resulted in the removal of 22 items on the basis of large MIs (above 10), and SRs > ±2.58, and assessment of item content. The resulting 9 factor model consisting of 28 items was found to fit the data satisfactorily (CMIN/DF = 2.51; GFI = 0.87, CFI = 0.91, SRMR = 0.04 and RMSEA = 0.05). The new factors demonstrated good internal reliability. The PC PMOS did not demonstrate good convergent validity with the correlation between total PC PMOS score and practice staff patient safety score failing to reach statistical significance (r = −0.64, k = 9, P = 0.06). It demonstrated good discriminant validity between primary care practices (F = 2.64, df = 72, P<0.001).ConclusionValidation of the PC PMOS has led to a reliable and valid 28 item patient measure of patient safety in primary care. It could enhance or complement current data collection methods used in primary care to identify and prevent error, and is also a practical response to the growing need to find appropriate and effective ways of involving patients in improving patient safety.

scholarly journals Validation of the Primary Care Patient Measure of Safety (PC PMOS) questionnaire

2018 ◽  
Vol 28 (5) ◽  
pp. 389-396 ◽  
Author(s):  
Sally J Giles ◽  
Sahdia Parveen ◽  
Andrea L Hernan
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Primary Care Patient ◽  
Care Patient ◽  
Internal Reliability ◽  
Practice Staff ◽  
Care Practices ◽  
Primary Care Practices

BackgroundThe Primary Care Patient Measure of Safety (PC PMOS) is designed to capture patient feedback about the contributing factors to patient safety incidents in primary care. It required further reliability and validity testing to produce a robust tool intended to improve safety in practice.Method490 adult patients in nine primary care practices in Greater Manchester, UK, completed the PC PMOS. Practice staff (n = 81) completed a survey on patient safety culture to assess convergent validity. Confirmatory factor analysis (CFA) assessed the construct validity and internal reliability of the PC PMOS domains and items. A multivariate analysis of variance was conducted to assess discriminant validity, and Spearman correlation was conducted to establish test–retest reliability.ResultsInitial CFA results showed data did not fit the model well (a chi-square to df ratio (CMIN/DF) = 5.68; goodness-of-fit index (GFI) = 0.61, CFI = 0.57, SRMR = 0.13 and root mean square error of approximation (RMSEA) = 0.10). On the basis of large modification indices (>10), standardised residuals >± 2.58 and assessment of item content; 22 items were removed. This revised nine-factor model (28 items) was found to fit the data satisfactorily (CMIN/DF = 2.51; GFI = 0.87, CFI = 0.91, SRMR = 0.04 and RMSEA = 0.05). New factors demonstrated good internal reliability with average inter-item correlations ranging from 0.20 to 0.70. The PC PMOS demonstrated good discriminant validity between primary care practices (F = 2.64, df = 72, p < 0.001) and showed some association with practice staff safety score (convergent validity) but failed to reach statistical significance (r = −0.64, k = 9, p = 0.06).ConclusionThis study led to a reliable and valid 28-item PC PMOS. It could enhance or complement current data collection methods used in primary care to identify and prevent error.

scholarly journals Using the electronic health record to build a culture of practice safety: evaluating the implementation of trigger tools in one general practice

2018 ◽  
Vol 68 (669) ◽  
pp. e279-e285 ◽  
Author(s):  
Tom Margham ◽  
Natalie Symes ◽  
Sally A Hull
Keyword(s):  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Patient Safety ◽  
Ease Of Use ◽  
High Yield ◽  
Case Review ◽  
Patients At Risk ◽  
Barriers To Implementation ◽  
Narrative Evaluation

BackgroundIdentifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations.AimThis study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety.Design and settingMixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice.MethodThe project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians.ResultsTrigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs’ work is generally reactive and GPs welcomed an approach that identified patients who were ‘under the radar’ of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time.ConclusionElectronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks.

scholarly journals Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020870 ◽  
Author(s):  
Rebecca Lauren Morris ◽  
Susan Jill Stocks ◽  
Rahul Alam ◽  
Sian Taylor ◽  
Carly Rolfe ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
National Survey ◽  
Healthcare Professionals ◽  
Primary Care Patient ◽  
Research Priorities ◽  
Care Patient ◽  
Nominal Group ◽  
Safety Research ◽  
Research Questions

ObjectivesTo identify the top 10 unanswered research questions for primary care patient safety research.DesignA modified nominal group technique.SettingUK.ParticipantsAnyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions.Main outcomesA top 10, and top 30, future research questions for primary care patient safety.Results443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality.ConclusionsThis study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety.

Sign in / Sign up

Export Citation Format

Share Document