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.

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 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 Patient Safety Culture Assessment in Primary Care Settings in Greece

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 880
Author(s):  
Ioannis Antonakos ◽  
Kyriakos Souliotis ◽  
Theodora Psaltopoulou ◽  
Yannis Tountas ◽  
Maria Kantzanou
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Safety Culture ◽  
Health Professionals ◽  
Improve Patient Safety ◽  
Patient Safety Culture ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool ◽  
Primary Care Settings

Introduction: A positive safety culture is considered a pillar of safety in health organizations and the first crucial step for quality health services. In this context, the aim of this study was to set a reference evaluation for the patient safety culture in the primary health sector in Greece, based on health professionals’ perceptions. Methods: We used a cross-sectional survey with a 62% response rate (n = 459), conducted in primary care settings in Greece (February to May 2020). We utilized the “Medical Office Survey on Patient Safety Culture” survey tool from the Agency for Healthcare Research and Quality (AHRQ). The study participants were health professionals who interacted with patients from 12 primary care settings in Greece. Results: The most highly ranked domains were: “Teamwork” (82%), “Patient Care Tracking/Follow-up” (80% of positive scores), and “Organizational Learning” (80%); meanwhile, the lowest-ranked ones were: “Leadership Support for Patient Safety” (62%) and “Work Pressure and Pace” (46%). The other domains, such as “Overall Perceptions of Patient Safety and Quality” (77%), “Staff Training“ (70%), “Communication about Error” (70%), “Office Processes and Standardization” (67%), and “Communication Openness” (64%), ranked somewhere in between. Conclusions: A positive safety culture was identified in primary care settings in Greece, although weak areas concerning the safety culture should be addressed in order to improve patient safety.

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.

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