Abstract
BackgroundSuccessful endorsement of quality indicators hinges on the readiness and acceptability of care providers for those measures. This paper aims to assess the readiness of care providers in the primary health-care sector in Lebanon for the implementation of quality and patient safety indicators.MethodsA cross-sectional survey methodology was utilized to gather information from 943 clinical care providers working at 123 primary health-care centres in Lebanon. The questionnaire included two sections: the first assessed four readiness dimensions (appropriateness, management support, efficacy, and personal valence) of clinical providers to use quality and safety indicators using the Readiness for Organization Change (ROC) scale, and the second section assessed the safety attitude at the primary care centre utilizing the Agency of Health Research and Quality (AHRQ) Safety Attitude Questionnaire (SAQ)-Ambulatory version.ResultsAlthough two thirds (66 %) of respondents indicated readiness for implementation of quality and patient safety indicators in their centres, there appear to be differences by professional group. Physicians displayed the lowest scores on all readiness dimensions except for personal valence which was the lowest among nurses (60 %). In contrast, allied health professionals displayed the highest scores across all readiness dimensions. Generally, respondents reflected a positive safety attitude climate in the centres. Yet, there remain a few areas of concern related to punitive culture (only 12.8 % agree that staff should not be punished for reported errors/incidents), continuity of care (41.1 % believe in the negative consequences of lack in continuity of care process), and resources (48.1 % believe that the medical equipment they have are adequate). Providers with the highest SAQ score had 2.7, 1.7, 7 and 2.4 times the odds to report a higher readiness on the appropriateness, efficacy, management and personal valence ROC subscales, respectively (P value <0.01). Nurses displayed relatively lower odds of readiness across all other ROC subscales as compared to all other providers.ConclusionHealth-care providers at the primary health care (PHC) centres in Lebanon are ready to engage in employing quality and patient safety indicators. This is a key finding given the active efforts by the MoPH to strengthen the quality culture in the PHC sector through various strategies.
Highlights
Primary health-care centres (PHCCs) constitute the setting in which local communities are most likely to receive ‘practical, scientifically sound and socially acceptable’ care that is both sustainable and universally accessible [1]
This study aims to reveal the safety climate and overall capacities of PHCCs and their employees to fulfil other health-care quality improvement requirements, such as those required for the national accreditation of primary health-care organizations in Lebanon
Since those centres did not satisfy the requirements of the Ministry of Public Health (MoPH) criteria for PHCCs, they were excluded from the survey as they would probably not be included in the implementation of the change
Summary
Primary health-care centres (PHCCs) constitute the setting in which local communities are most likely to receive ‘practical, scientifically sound and socially acceptable’ care that is both sustainable and universally accessible [1]. Thirty years after the Declaration that officially highlighted the significance of PHC in addressing the health-care needs of populations in 1978, PHC was again at the centre stage of the international health-care agenda with the publication of the 2008 World Health Report ‘Primary Health Care: more than ever’ [2]. This renewed interest in PHC has been coupled with an increased attention to patient safety and quality of care. This paper aims to assess the readiness of care providers in the primary health-care sector in Lebanon for the implementation of quality and patient safety indicators
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