Abstract
BackgroundEstimates suggest that approximately 1 in 10 patients admitted to hospital experience an adverse event resulting in harm. Methods to improve patient safety have concentrated on developing safer systems of care and promoting changes in professional behaviour. There is a growing international interest in the development of interventions that promote the role of patients preventing error, but limited evidence of effectiveness of such interventions. The present study aims to undertake a randomised controlled trial of patient-led teaching of junior doctors about patient safety.Methods/DesignA randomised cluster controlled trial will be conducted. The intervention will be incorporated into the mandatory training of junior doctors training programme on patient safety. The study will be conducted in the Yorkshire and Humber region in the North of England. Patients who have experienced a safety incident in the NHS will be recruited. Patients will be identified through National Patient Safety Champions and local Trust contacts. Patients will receive training and be supported to talk to small groups of trainees about their experiences. The primary aim of the patient-led teaching module is to increase the awareness of patient safety issues amongst doctors, allow reflection on their own attitudes towards safety and promote an optimal culture among the doctors to improve safety in practice. A mixture of qualitative and quantitative methods will be used to evaluate the impact of the intervention, using the Attitudes to Patient Safety Questionnaire (APSQ) as our primary quantitative outcome, as well as focus groups and semi-structured interviews.DiscussionThe research team face a number of challenges in developing the intervention, including integrating a new method of teaching into an existing curriculum, facilitating effective patient involvement and identifying suitable outcome measures.Trial RegistrationCurrent controlled Trials: ISRCTN94241579
Highlights
Estimates suggest that approximately 1 in 10 patients admitted to hospital experience an adverse event resulting in harm
The research team face a number of challenges in developing the intervention, including integrating a new method of teaching into an existing curriculum, facilitating effective patient involvement and identifying suitable outcome measures
The present study aims to develop an intervention based on patients as teachers in training junior doctors about patient safety and to evaluate the impact of this intervention on safety attitudes in a randomised controlled trial
Summary
Patient safety is an international health priority [1]. Estimates suggest that approximately 1 in 10 patients admitted to National Health Services hospitals in the UK is involved in an incident which results in harm to patients [2] with a subsequent cost to the NHS of over £2 billion [3]. Strategies to reduce patient safety incidents have shifted the focus from a person centred approach where errors are viewed as occurring as the result of the individual, to developing a systems approach whereby individual error is accepted and. Recent reviews of the literature have highlighted: a lack of initiatives to promote patient and/or carer involvement in patient safety; major gaps in our knowledge about the nature and impact of patient involvement; little evidence of the feasibility or effectiveness of patient centred interventions and uncertainty over their acceptability amongst patients and health professionals [5,6]. There is a paucity of research which examines the use of patient stories in a safety context; preliminary research suggests that this is a feasible method for communicating concerns about patient safety to healthcare professionals [6]. The present study aims to develop an intervention based on patients as teachers in training junior doctors about patient safety and to evaluate the impact of this intervention on safety attitudes in a randomised controlled trial
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