scholarly journals Reporting and Using Near-miss Events to Improve Patient Safety in Diverse Primary Care Practices: A Collaborative Approach to Learning from Our Mistakes

2015 ◽  
Vol 28 (4) ◽  
pp. 452-460 ◽  
Author(s):  
S. Crane ◽  
P. D. Sloane ◽  
N. Elder ◽  
L. Cohen ◽  
N. Laughtenschlaeger ◽  
...  
2015 ◽  
Vol 06 (01) ◽  
pp. 136-147 ◽  
Author(s):  
D. Gans ◽  
J. White ◽  
R. Nath ◽  
J. Pohl ◽  
C. Tanner

Summary Background: The role of electronic health records (EHR) in enhancing patient safety, while substantiated in many studies, is still debated. Objective: This paper examines early EHR adopters in primary care to understand the extent to which EHR implementation is associated with the workflows, policies and practices that promote patient safety, as compared to practices with paper records. Early adoption is defined as those who were using EHR prior to implementation of the Meaningful Use program. Methods: We utilized the Physician Practice Patient Safety Assessment (PPPSA) to compare primary care practices with fully implemented EHR to those utilizing paper records. The PPPSA measures the extent of adoption of patient safety practices in the domains: medication management, handoffs and transition, personnel qualifications and competencies, practice management and culture, and patient communication. Results: Data from 209 primary care practices responding between 2006–2010 were included in the analysis: 117 practices used paper medical records and 92 used an EHR. Results showed that, within all domains, EHR settings showed significantly higher rates of having workflows, policies and practices that promote patient safety than paper record settings. While these results were expected in the area of medication management, EHR use was also associated with adoption of patient safety practices in areas in which the researchers had no a priori expectations of association. Conclusions: Sociotechnical models of EHR use point to complex interactions between technology and other aspects of the environment related to human resources, workflow, policy, culture, among others. This study identifies that among primary care practices in the national PPPSA database, having an EHR was strongly empirically associated with the workflow, policy, communication and cultural practices recommended for safe patient care in ambulatory settings. Citation: Tanner C, Gans D, White J, Nath R, Pohl J. Electronic health records and patient safety – co-occurrence of early EHR implementation with patient safety practices in primary care settings. Appl Clin Inf 2015; 6: 136–147http://dx.doi.org/10.4338/ACI-2014-11-RA-0099


Health Policy ◽  
2010 ◽  
Vol 97 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Sander Gaal ◽  
Pieter van den Hombergh ◽  
Wim Verstappen ◽  
Michel Wensing

2020 ◽  
Author(s):  
Katarzyna Kosiek ◽  
Iwona Staniec ◽  
Maciej Godycki-Cwirko ◽  
Adam Depta ◽  
Anna Kowalczyk

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.


2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Clara González-Formoso ◽  
María Victoria Martín-Miguel ◽  
Ma José Fernández-Domínguez ◽  
Antonio Rial ◽  
Fernando Isidro Lago-Deibe ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katarzyna Kosiek ◽  
Iwona Staniec ◽  
Maciej Godycki-Cwirko ◽  
Adam Depta ◽  
Anna Kowalczyk

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.


2021 ◽  
Author(s):  
Maria J Serrano-Ripoll ◽  
Maria A. Fiol-DeRoque ◽  
José M. Valderas ◽  
Rocío Zamanillo-Campos ◽  
Joan Llobera ◽  
...  

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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