Patient Safety Policy in Long-Term Care: A Research Protocol to Assess Executive WalkRounds to Improve Management of Early Warning Signs for Patient Safety.

Loes Van Dusseldorp,Lisette Schoonhoven,Hub Hamers,Theo Van Achterberg

doi:10.2196/resprot.3256

Abstract

BackgroundAt many hospitals and long-term care organizations (such as nursing homes), executive board members have a responsibility to manage patient safety. Executive WalkRounds offer an opportunity for boards to build a trusting relationship with professionals and seem useful as a leadership tool to pick up on soft signals, which are indirect signals or early warnings that something is wrong. Because the majority of the research on WalkRounds has been performed in hospitals, it is unknown how board members of long-term care organizations develop their patient safety policy. Also, it is not clear if these board members use soft signals as a leadership tool and, if so, how this influences their patient safety policies.ObjectiveThe objective of this study is to explore the added value and the feasibility of WalkRounds for patient safety management in long-term care. This study also aims to identify how executive board members of long-term care organizations manage patient safety and to describe the characteristics of boards.MethodsAn explorative before-and-after study was conducted between April 2012 and February 2014 in 13 long-term care organizations in the Netherlands. After implementing the intervention in 6 organizations, data from 72 WalkRounds were gathered by observation and a reporting form. Before and after the intervention period, data collection included interviews, questionnaires, and studying reports of the executive boards. A mixed-method analysis is performed using descriptive statistics, t tests, and content analysis.ResultsResults are expected to be ready in mid 2014.ConclusionsIt is a challenge to keep track of ongoing development and implementation of patient safety management tools in long-term care. By performing this study in cooperation with the participating long-term care organizations, insight into the potential added value and the feasibility of this method will increase.

Highlights

Good quality of care and patient safety require leadership involvement from both professionals and managers [1,2,3,4,5,6]
Analyses of recent safety incidents in health care in the Netherlands show that there is a lack of governance on patient safety [7]
This is related to the fact that allocation of responsibilities for patient safety between professionals and managers is not clearly defined, and that board members, who have the final responsibility, lack leadership tools to improve and secure patient safety at an organizational level [7]

Summary

Introduction

Good quality of care and patient safety require leadership involvement from both professionals and managers [1,2,3,4,5,6]. Twijnstra and Gudde [9] identified the professional relationship between board members and professionals as an important precondition for safety policy in hospitals and in long-term care settings. This relationship should be based on mutual trust to allow the board to pick up on indirect signs (eg, conflicts between the medical staff or discontent of staff members). The majority of the research on patient safety and Executive WalkRounds has been performed in hospitals It is unknown how board members of long-term care organizations develop their patient safety policy. This study aimed to identify how board members of long-term care organizations manage patient safety and to describe the characteristics of the boards

Study Design and Setting

Participants and Sample

Limitations

Findings

Conflicts of Interest