Abstract
BackgroundOrganisational problems contribute to many errors in healthcare delivery. Our objective was to identify the most important organisational items in primary care which could be targeted by programs to improve patient safety.MethodsA web-based survey was undertaken in an international panel of 65 experts on patient safety from 20 countries. They were asked to rate 52 patient safety items on a five-point Likert scale which regards importance of each item for use for educational interventions to improve patient safety.ResultsThe following 7 organizational items were regarded ‘extremely important’ by more than 50% of the experts: the use of sterile equipment with small surgical procedures (63%), the availability of adequate emergency drugs in stock (60%), regular cleaning of facilities (59%), the use of sterile surgical gloves when recommended (57%), the availability of at least one adequately trained staff member to deal with collapse and need for resuscitation (56%), adequate information handover when a patient is discharged from the hospital (56%) and periodically training of GPs in basic life support and other medical emergencies (53%).ConclusionSeven organisational items were consistently prioritized; other items may be relevant in specific countries only. The logical next step is to develop and evaluate interventions targeted at these items.
Highlights
Organisational problems contribute to many errors in healthcare delivery
An inventory in an international panel of primary care experts found that continuing education of health professionals on patient safety was perceived as highly relevant and currently lacking [10]
Our aim was to document the relevance of specific organisational items for patient safety to support the development of educational programs for enhancing patient safety in primary care
Summary
Our objective was to identify the most important organisational items in primary care which could be targeted by programs to improve patient safety. Patient safety receives increased attention worldwide, in primary care [1,2]. The challenge is to enhance patient safety in the high-volume, low-risk setting of primary care, while avoiding defensive medicine or heavy bureaucratic control structures. Interventions to improve patient safety include reporting and analysis of incidents, and measurement. Organizational problems, such as suboptimal control of repeat prescriptions or inadequate routines for cleaning equipment, contribute to patient safety incidents. Focusing educational interventions (e.g. audit and feedback, prospective risk analysis) on organisation of primary care is potentially feasible and effective to improving patient safety. The question is which items need to be considered in educational programs to enhance patient safety
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