\u2018The big buzz\u2019: a qualitative study of how safe care is perceived, understood and improved in general practice

Carl De Wet,Catherine O’Donnell,Paul Bowie

doi:10.1186/s12875-018-0772-z

Carl De Wet, Catherine O’Donnell + Show 1 more

Open Access

https://doi.org/10.1186/s12875-018-0772-z

Copy DOI

Abstract

BackgroundExploring frontline staff perceptions of patient safety is important, because they largely determine how improvement interventions are understood and implemented. However, research evidence in this area is very limited. This study therefore: explores participants’ understanding of patient safety as a concept; describes the factors thought to contribute to patient safety incidents (PSIs); and identifies existing improvement actions and potential opportunities for future interventions to help mitigate risks.MethodsA total of 34 semi-structured interviews were conducted with 11 general practitioners, 12 practice nurses and 11 practice managers in the West of Scotland. The data were thematically analysed.ResultsPatient safety was considered an important and integral part of routine practice. Participants perceived a proportion of PSIs as being inevitable and therefore not preventable. However, there was consensus that most factors contributing to PSIs are amenable to improvement efforts and acknolwedgement that the potential exists for further enhancements in care procedures and systems. Most were aware of, or already using, a wide range of safety improvement tools for this purpose. While the vast majority was able to identify specific, safety-critical areas requiring further action, this was counter-balanced by the reality that additional resources were a decisive requirment.ConclusionThe perceptions of participants in this study are comparable with the international patient safety literature: frontline staff and clinicians are aware of and potentially able to address a wide range of safety threats. However, they require additional resources and support to do so.

Highlights

Exploring frontline staff perceptions of patient safety is important, because they largely determine how improvement interventions are understood and implemented
A total of 34 interviews were held with general practitioners, practice nurses and 11 practice managers
One participant had the dual role of practice nurse and manager and one general practitioners (GP) initially agreed to Practice Patient GPs (n) no list sizea Partners Other

Summary

Introduction

Exploring frontline staff perceptions of patient safety is important, because they largely determine how improvement interventions are understood and implemented. The Scottish Patient Safety Program (SPSP) is an example of this approach [7] It initially focused on specific, high-risk processes in secondary and tertiary care centres only, before being extended into primary care [4]. There are a range of potential improvement methods, tools and interventions available that have been adapted and contextualised for the general practice setting [8,9,10,11,12,13,14,15] Despite these initiatives and a growing research agenda, there is still limited evidence that the standards of care, including in general practice, have been significantly improved as a result of specific interventions. The second issue is whether the intended users of these complex health care interventions are willing and able to effectively implement them and continue to use them

Objectives

Results

Discussion

Conclusion