Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway

Trond Kongsvik,Kristin Halvorsen,Gudveig Gjøsund,Tonje Osmundsen

doi:10.1186/s12913-016-1708-8

Abstract

BackgroundPatient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories.MethodsA qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel.ResultsThe LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers.ConclusionsAs a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.

Highlights

Patient safety has gained less attention in primary care in comparison to specialised care
We find that Local medical centre (LMC) engage in three main areas related to patient safety, namely information exchange, competence building, and quality assurance
During the analysis, we constructed three categories that dealt with the role LMCs play in relation to patient safety

Summary

Introduction

Patient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. Related to specialised health care, an estimated 8–12 % of patients admitted to hospitals in the European Union (EU) suffer from adverse events while receiving health care [1]. As a response to such numbers, there have been several initiatives to strengthen patient safety and quality in health care during the last decade, as well as on the transnational level, such as through the World Health Organization’s (WHO) Patient Safety Program and the Patient Safety and Quality of Care Working group of the EU.

Methods

Results

Discussion

Conclusion