Assess Patient Safety Research Articles

Magnetic Intramedullary Lengthening Nails and MRI Compatibility.

Magnetic intramedullary nails (IMNs) are fully implantable lengthening devices that became available in the United States in 2011 for the correction of limb length discrepancies. This device represents a major advancement in the field of limb lengthening surgery as it is typically tolerated better than external fixation. Unlike traditional IMNs, surgeons recommend routine removal following limb lengthening. One such reason involves patient safety as it pertains to magnetic resonance imaging (MRI). Theoretical concerns with MRI exposure include implant migration, implant heating, and involuntary elongation of the lengthening mechanism. Our study seeks to investigate the effects of MRI on intramedullary magnetic lengthening nails. Twenty-five intramedullary magnetic nails were studied. One nail was placed within the magnetic field to measure maximum magnetic force. Nails were then scanned using standard knee MRI protocols, 12 in 3 T and 12 in 1.5 T MRI scanners. The following parameters were measured: (1) distraction of the implants after MRI exposure, (2) temperature before and after MRI, and (3) internal distraction force before and after MRI. Maximum magnetic force was found to be 2 lbs. There was no involuntary distraction of the implants after MRI. Temperature increase of 3.3°C was found in the femoral nails and 3.6°C in the tibial nails that were exposed to 3 T MRI. This increase did not reach or exceed physiological temperature of 37°C. Distraction force was reduced by 61.7% in the femoral nails and 89.6% in the tibial nails after subjected to 3 T MRI. There was no reduction in distraction force after exposure to 1.5 T MRI. Recommendations for routine removal of magnetic IMNs for safety concerns should be reconsidered. Exposure to 3 T MRI should be avoided in patients who are still undergoing lengthening or with plans for future lengthening with magnetic IMNs. To assess patient safety and implant function after magnetic IMNs have been exposed to MRI.

Global trigger tool value for revealing of unwanted events related to medical care in pediatrics

Global trigger tool algorithm was described by this article. Global triggers are the special tools to increase inpatients’ safety, which is based on identifying of unwanted events’ high-risk indicators in medical documents. Global trigger tool was initially developed for adult patients and only recent several years there have been … efforts to create special pediatric algorithm. At the moment Global Assessment of Pediatric Patient Safety (GAPPS) is it. There are triggers of that algorithm in the article. Moreover, development process was described and foreign studies with GAPPS were demonstrated here. That tool while have not been implemented into Russian pediatrics. It is more effective approach to identify unwanted events by triggers compared to spontaneous messages in order to increase inpatients’ safety.

Spin-off use of adverse events data: why and how. The case of FDA’s MAUDE

Objectives: This paper attempts to measure the impact of the second stage exploitation of FDA’s MAUDE database on patient safety, technology assessment and other scientific fields.
 
 Methods: Five bibliographic databases have been queried with the terms “Manufacturer and User Facility Device Experience Database” and “FDA AND MAUDE”. A number of eligibility criteria where applied on the results, which led to a final group of 117 papers. An extensive study of these publications resulted to a number of interesting findings.
 
 Results: The results concern the evolution of the database exploitation over time, and are examined according to the device groups that the identified papers are referring to, the research goals of these papers, the reasons that led the authors of these papers to use MAUDE data and finally how these data were used within their research methodology.
 
 Conclusions: Patient safety and technology assessment are two of the scientific fields on which MAUDE database has the greatest impact. On average, more than 10 peer-reviewed papers each year involve MAUDE data as a mean to reach their research goals. This proves that MAUDE is an exploitable and valuable data source for research in these scientific fields.

An intelligent algorithm for assessing patient safety culture and adverse events voluntary reporting using PCA and ANFIS.

Patient safety culture (PSC) as a main component of the organizational culture plays a key role in providing safe, effective and economic cares and services in healthcare organizations. PSC provides a way to assist hospitals in order to improve patient safety and prevent medical errors. The present study aimed to measure PSC and healthcare professionals' attitude towards voluntary reporting of adverse events in two hospitals in Iran and to develop a hybrid intelligent approach for modeling PSC grades. The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and a two-part questionnaire were used for examining the PSC and healthcare professionals' attitude towards voluntary reporting of adverse events, respectively. Principal component analysis (PCA) was applied to extract of the main components in the HSOPSC questionnaire and to construct 12 dimensions of patient safety culture. The overall grade of patient safety culture was modeled using adaptive neuro-fuzzy inference systems (ANFIS) as a classification problem. Almost half of the participants have experienced a medical error and adverse events. The PSC grade was acceptable from the point of view of 55.5% and 50% of participants in hospital No.1 and hospital No.2, respectively. The overall accuracy of ANFIS in modeling overall grades of patient safety culture in both study hospitals was 0.84. Of those individuals gave an acceptable grade on patient safety culture in both study hospitals, more than 50% believed that all medical errors and near misses should be reported. The ANFIS algorithm was proposed for modeling and predicting of PSC for healthcare organizations. The results confirm the capability of the proposed model to predict patient safety grades in healthcare settings.

Use of Simulations to Improve Pharmacy Students’ Knowledge, Skills, and Attitudes About Medication Errors and Patient Safety

Objective. To design and evaluate the use of simulations in preparing students to identify and reduce medication errors and promote patient safety. Methods. Third-year pharmacy students used methods of root cause analysis (RCA) to determine the cause of a medication error in three simulated pharmacy settings. Before and after the activity, students completed an anonymous survey. They also completed a modified Healthcare Professionals Patient Safety Assessment instrument to measure changes in their knowledge, skills, and attitudes. Results. Ninety out of 165 students submitted complete data sets for analysis. Students demonstrated significant changes in knowledge, skills, and attitudes regarding medication errors. They felt they could find the cause of an error, identify factors leading to an error, and work with a team to prevent error recurrence. They also demonstrated an increase in knowledge about medication-related errors and the root cause analysis process. Conclusion. Students used RCA methods to discover medication errors in three simulated pharmacy settings. Students improved their knowledge, skills, and attitudes regarding medication errors through this process.

Strategies for Improving Physician-patient Relationship in China Assessing Patient Safety Culture from the Perceptions of Physicians

Creating a better patient safety culture in hospitals has become a critical topic for providing quality medical services globally. In 2014, there were 115 thousand cases of medical disputes in China. Understanding physicians’ perceptions toward patient safety is a critical issue for hospitals to monitor safety situations for patients. This study aims to identify physicians’ attitudes toward patient safety via the investigation of Sexton et al. (2006)’s Safety Attitude Questionnaire (SAQ), to provide implications for improving medical quality. Pearson’s correlation analysis was used to demonstrate the relationships among six patient safety culture dimensions. Regression analysis was subsequently conducted to realize the degree of influence among important dimensions. Physicians was asked to answer the SAQ in a tertiary hospital in China in 2017. The results of Pearson correlation analysis demonstrate that safety climate had strong and positive relationship with working conditions and teamwork climate, respectively. Similarly, regression results illustrated that working conditions, teamwork climate, and teamwork climate had noteworthy effects on safety climate. The examination of patient safety culture from the viewpoints of physicians provides a basis for hospital managers to monitor the medical quality and service for patients. Hospital managers need to pay more efforts to the essentially important elements of patient safety, such as working conditions, teamwork climate, and job satisfaction, to continuously improve physician-patient relationship.Â

Patient safety culture in a university hospital.

ABSTRACTObjective:to assess patient safety culture in a university hospital. Method:cross-sectional study with data collection through the Hospital Survey on Patient Safety Culture applied in electronic device. A total of 381 employees were interviewed, corresponding to 46% of the sum of eligible professionals. Data were analyzed descriptively. the Cronbach’s alpha was used to calculate the frequency and reliability. Results:most were women (73%) from the nursing area (50%) and with direct contact with patients (82%). The composites related to “teamwork within units” (58%, α=0.68), “organizational learning - continuous improvement” (58%, α=0.63), “supervisor/manager expectations and actions promoting patient safety” (56%, α=0.73) had higher positive responses. Nine composites had low positive responses, with emphasis on “nonpunitive response to error” (18%, α=0.40). Only the item “in this unit, people treat each other with respect” had positive response above 70%. The patient safety assessment in the work unit was positive for 36% of employees, however only 22% reported events in past year. Conclusion:the findings revealed weaknesses in the safety culture at the hospital, with emphasis on culpability.

Reprocessed single-use devices in laparoscopy: assessment of cost, environmental impact, and patient safety.

Reprocessed single-use devices in laparoscopy: assessment of cost, environmental impact, and patient safety.

Analisis Persiapan Pelaksanaan Patient Safety di Ruang Rawat Inap (Studi Kasus di RSUD Kabupaten Bima)

The era of globalization brings the very rapid effects in the development of cutting-edge medical technology. These conditions have an impact on medical services is very complex and very potentially cause errors, so that the necessary improvement of the quality of health services. Patient safety is one important component in the quality of health services. Improving patient safety measures needed to prevent and minimize unexpected events (KTD). Nurses are one of the health workers who are at the front of health services have a very important role in improving patient safety. The aim of this research to assess patient safety analysis on the Attitudes of ward nurses in public district general hospital Bima and in particular to know the components of patient safety climate Attitudes include teamwork, job conditions, employment decisions, factors that support and hinder patient safety Attitudes. The study was descriptive qualitative. Subjects were nurses of three subjects and patients with interviews. Data collection techniques in this study are the tape recorder. Qualitative data analysis technique that was using descriptive analysis techniques to describe the data in the field were analyzed and concluded. Attitudes of patient safety component of work climate Attitudes patient safety team showed low, job satisfaction shows high patient safety Attitudes at the components of job satisfaction, working conditions showed low Attitudes patient safety, because of logistical and laboratory support is still lacking. Components of patient safety high Attitudes namely job satisfaction component of patient safety is low Attitudes climate of teamwork and conditions of employment because of logistical and laboratory support is still lacking.

Quality Counts, but How Do We Really Measure It?

Quality Counts, but How Do We Really Measure It?

Improving patient safety in Palestinian hospitals: a cross-sectional and retrospective chart review study

BackgroundPatient safety is the central component of health-care quality. There is a lack of patient safety data in the occupied Palestinian territory. The aim of this study was to assess patient safety and explore relationships between patient safety culture and the prevalence of adverse events at the department level. MethodsBetween May 25, 2009, and June 1, 2010, the Arabic validated Hospital Survey on Patient Safety Culture was used to measure the norms and perceptions of health professionals regarding safety. The survey was used in eight medical departments in two hospitals (Al Makassed hospital and Al Ahli hospital in the West Bank; four departments per hospital). During the same period, a retrospective review of medical records was done to identify adverse events using the validated Palestinian version of the Global Trigger Tool. Descriptive statistics and Spearman's rho coefficient were used. Ethical approval was obtained from the participating hospital boards and the Palestinian health authorities, and written consent was obtained from participants. Findings640 randomly selected records (320 records per hospital) were reviewed, and 428 health-care workers participated in the safety culture assessment (response rate 74%). 213 (50%) participants were nurses, 163 (38%) were doctors, and 52 (12%) were other health-care professionals. Patients had a mean age of 44·2 years (SD 19·6; range 18–95) and a mean length of stay of 4·8 days (SD 5·6; range 1–70). 91 (14%) records included an adverse event. Adverse events were negatively associated with the aggregate safety culture (r=–0·905; p=0·0009), hospital management support (r=–0·881; p=0·0017), non-punitive response to errors (r=–0·731; p=0·019), communication and feedback on errors (r=–0·905; p=0·0009), teamwork (r=–0·886; p=0·0021), organisational learning (r=–0·778; p=0·011), and supervisor actions promoting patient safety (r=–0·857; p=0·0029), indicating that departments with a more positive patient safety culture had lower rates of adverse events. InterpretationsSafety must be improved for Palestinian patients. To promote patient safety, managers and policy makers should acknowledge and allocate resources for enhancing overall safety culture, hospital management support, non-punitive response, communication on errors, teamwork, organisational learning, and supervisor actions. FundingResearch and development, KU Leuven, Leuven, Belgium.

Professional Forces of Magnetism and Patient Safety Culture at Suez Canal University Hospitals

Background: Attainment of the forces of magnetism improves the recruitment and retention of nurses. Also, the higher levels of nurses' autonomy and empowerment in magnet hospitals improve patient safety culture. The need for assessing patient safety within hospitals and determining the areas of improvement become urgent. The aim of the study: This study aims to identify the relationship between the fourteen forces of magnetism and patient safety at Suez Canal University hospitals. Subject and method: A descriptive correlational design was utilized to carry out this study. A sample of 324 staff nurses was included in this study. The study was conducted in Suez Canal University Hospitals. Tools: two tools were used. Tool1: Forces of magnetism questionnaire was developed by the researcher. Tool2: Hospital survey on patient safety culture was adopted from Agency for healthcare research and quality (AHRQ) and modified by the researcher. Results: There are positive correlations between all forces of magnetism and patient safety at Suez Canal University Hospitals. There is a highly significant positive correlation between total magnetism and patient safety at Suez Canal University Hospitals. Conclusion: Suez Canal University Hospitals were evaluated by the majority of studied nurses as moderate magnetic hospitals. Only five dimensions of patient safety were considered as areas of potential improvement at Suez Canal University Hospitals. Recommendations: Modification of hospital policies of remaining and recruiting nurses and establishing a climate of communication openness, teamwork and non-punitive response to errors

Comparison of Outcomes Obtained After Regular Surgery Versus Live Operative Surgical Cases: Single-centre Experience with Green Laser Enucleation of the Prostate

BackgroundLive surgery remains controversial. Although it may improve surgical training and accelerate the dissemination of technical steps of surgical procedures, controversy exists regarding patient safety in live surgery. ObjectiveTo compare the perioperative outcomes of “en bloc” green laser enucleation of the prostate (GreenLEP) performed in workshops during live case demonstration (LCD) and in standard conditions (SCs). Design, setting, and participantsBetween June 2015 and January 2017, all consecutive patients who underwent GreenLEP for benign prostatic obstruction performed by a single surgeon were prospectively enrolled. Perioperative data and early postoperative complications according to Clavien–Dindo classification were collected. Workshop programmes started locally according to the European Association of Urology policy on live surgical events in June 2015 to enrol small groups of urologists in the GreenLEP technique. InterventionEndoscopic enucleation of the prostate using a GreenLight fibre. Outcome measurements and statistical analysisOutcomes were compared between the LCD and SC groups. Results and limitationsOf the 126 performed procedures, 37 were performed live during 17 LCDs with a median attendee number of 3. The patients’ baseline characteristics were similar in both groups. Intraoperative parameters were comparable: total energy of 62 [53; 77] versus 56kJ [44; 69] (p=0.068), operative time of 61 [53; 71] versus 55min [45; 66] (p=0.1), and morcellating time of 3 [3; 5] versus 4min [2; 6] (p=0.82) in the LCD versus SC group. The catheterisation time (2d [1; 2]) and length of hospital stay (2d [2; 3]) were similar. The overall complication rate was comparable in the LCD (18.9%) and SC (24.7%) groups (p=0.64). Preoperative parameters significantly improved from baseline without any significant differences between the two groups. Limitations included a small number of attendees/workshop, and case selections were made by the surgeon himself. ConclusionsGreenLEP was safe and provided satisfactory functional outcomes in both conditions. From this preliminary study, it seems that LCD did not jeopardise the surgeon’s skill or technique. Similar studies are required to further assess patient safety and outcomes associated with live surgical events. Patient summaryAccording to the surgeon expertise, endoscopic enucleation of the prostate performed during live case demonstration provided similar functional outcomes to that performed in standard condition and could therefore be considered a safe potential educational tool.

Efficacy of perianal nerve blockfor day care ano-rectal procedures

Aim of this study was to assess patient safety, comfort, satisfaction level and quality of anaesthesia in patients undergoing day care ano-rectal procedures performed under Perianal Nerve Block (PNB) in comparison with Spinal Anaesthesia (SA) in peripheral medicare settings. MATERIAL AND METHODS: The study was a prospective, single centre study performed over a period of two years on 65 patients scheduled for various day care ano-rectal procedures. The patients were randomized to receive PNB or SA. The PNB was established using a mixture of 20ml of 2% lignocaine Hydrochloride (plain) and 20ml of 0.5% Bupivacaine Hydrochloride (plain) by four point perianal injection with Perianal subcutaneous infiltration augmentation technique whereas in all SA patients, the spinal block was established using 2 ml of 0.5% Bupivacaine (heavy) using 25G spinal needle in sitting position. All patients received premedication in the form of Inj Glycopyrrolate 0.2mg/iv and Inj Ondansetrone 8mg/iv. Patients were thereafter evaluated for pain and discomfort during the establishment of anesthesia, per-operatively and postoperatively for three days using a 10 point Visual Analogue Scale (VAS) and patient satisfaction level (1-5 point score). RESULTS: A total population of 65 patients out of 90 was found eligible for the study and were divided into two groups to either receive spinal anaesthesia (SA group, n=33) or Perianal nerve block (PNB group, n=32). Mean VAS during establishment of nerve block was 3.625 in PNB group and 1.2424 in SA group. Intra-operatively, VAS score was not very significantly variable in both the study groups. Mean VAS for post-operative pain during initial 12 hrs was 2.437 in PNB group and 5.878 in SA group.(P

The feasibility of an interactive voice response system (IVRS) for monitoring patient safety after discharge from the ED

BackgroundReturn ED visits are frequent and may be due to adverse events: adverse outcomes related to healthcare received. An interactive voice response system (IVRS) is a technology that translates human...

Systematic psychometric review of self-reported instruments to assess patient safety culture in primary care.

To give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of these instruments. A key condition for improving patient safety is creating a supportive safety culture to identify weaknesses and to develop improvement strategies so recurrence of incidents can be minimized. However, most tools to measure and strengthen safety culture have been developed and tested in hospitals. Nevertheless, primary care is facing greater risks and a greater likelihood of causing unintentional harm to patients. A systematic literature review of research evidence and psychometric properties of self-reported instruments to assess patient safety culture in primary care. Three databases until November 2016. The review was carried out according to the protocol for systematic reviews of measurement properties recommended by the COSMIN panel and the PRISMA reporting guidelines. In total, 1.229 records were retrieved from multiple database searches (Medline=865, Web of Science=362 and Embase=2). Resulting from an in-depth literature search, 14 published studies were identified, mostly originated from Western high-income countries. As these studies come with great diversity in tools used and outcomes reported, comparability of the results is compromised. Based on the psychometric review, the SCOPE-Primary Care survey was chosen as the most appropriate instrument to measure patient safety culture in primary care as the instrument had excellent internal consistency with Cronbach's alphas ranging from 0.70-0.90 and itemfactor loadings ranging from 0.40-0.96, indicating a good structural validity. The findings of the present review suggest that the SCOPE-Primary Care survey is the most appropriate tool to assess patient safety culture in primary care. Further psychometric techniques are now essential to ensure that the instrument provides meaningful information regarding safety culture.

Towards promoting patient safety practices: Baseline assessment of patient safety culture in three private hospitals

ABSTRACT The study aimed to: assess patient safety culture in three private hospitals, define strengths and weaknesses in patient safety culture, and examine the socio-demographic determinants of patient safety culture. A cross-sectional study was conducted among 1193 healthcare providers and administrators with 68.4% response rate. A locally customized hospital version of the Patient Safety Culture Survey (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ) was used. The mean score of overall perception of safety and frequency of event reporting were 3.4/5.0 and 4.0/5.0, respectively. ‘Excellent’ and ‘very good’ overall grade on patient safety was reported by 28.9 and 55.3% of participants, respectively. About half of participants reported no events in the last 12 months, while 31.4% reported 1–2 events. The strength areas were teamwork within units, organizational learning, and continuous improvement composite dimensions. However, the areas that required improvement were supervisor expectations, actions promoting patient safety, and hospital handoffs and transitions. Higher level of education, nursing career, training on patient safety, having direct communication with patients and working in small hospitals were the determinants of better patient safety culture practice. Hospital managers and policy makers ought to heighten the performance and practices within a non-punitive reporting atmosphere.

Effects of a Novel Microprocessor-Controlled Knee, Kenevo, on the Safety, Mobility, and Satisfaction of Lower-Activity Patients with Transfemoral Amputation

ABSTRACT Introduction Lower-activity persons with transfemoral amputation experience many comorbidities that limit their ability to satisfactorily use prosthetic knees and safely conduct their life activities. Kenevo is a novel microprocessor-controlled knee designed specifically to accommodate the needs of lower-activity individuals with transfemoral amputation. Materials and Methods A prospective observational study was conducted to collect first clinical experiences with Kenevo. Patient-reported measures were conducted to assess patient safety, mobility on level walking, stairs and ramps, as well as preference. In addition, feedback from certified prosthetists/orthotists was collected regarding fitting process, acclimation, and patient benefits. Results A total of 29 persons with amputation were fitted with Kenevo. Most of them had unilateral amputations and belonged to the K2 mobility group. Fitting the Kenevo resulted in a positive trend in the Locomotor Capabilities Index 5, Prosthetic Limb Users Survey of Mobility, and Houghton scores (p > 0.05). Kenevo use resulted in a significant reduction of wheelchair dependence for many subjects. Most subjects reported improvements in level walking during various speeds and on uneven ground as well as when walking and standing on ramps and traversing stairs. More than two-thirds of the subjects reported reduction in necessary concentration and perceived exertion when walking with Kenevo. Fear of falling was reduced in 50% of the subjects, whereas the number of subjects who never fell increased from 45% to 72% (p = 0.161) and those who never stumbled from 8% to 50% (p = 0.044). Finally, 89% of the subjects preferred Kenevo to their previous fitting. Conclusions First routine fittings of the new Kenevo microprocessor-controlled knee suggest that it offers numerous advantages to lower-activity persons with amputation. Improvements in functional mobility and safety were observed. Of the subjects, 89% preferred Kenevo over their previous knee. Higher-quality research is needed to confirm the conclusions reached in this observational study.

Measuring Harm in Hospitalized Children via a Trigger Tool

BackgroundThe 1999 report To Err Is Human published by the Institute of Medicine estimated that between 44,000 and 98,000 deaths occur each year in US hospitals due to medical errors. However, processes to detect medically induced harm remain inaccurate and inconsistent. Hospitalized pediatric patients are at high risk for adverse events, with published rates ranging between 1% and 11% of all hospitalizations. ObjectiveThe study aimed to use the Global Assessment of Pediatric Patient Safety (GAPPS) tool to detect adverse events in a pediatric inpatient setting of an academic medical center children's hospital and compare to internal incident reporting methods. MethodsNurse reviewers used the GAPPS tool during a retrospective chart review of 100 patients discharged from the children's hospital. Among the total 100 cases, 20 adverse events were discovered with the tool. Adverse events were validated by physician reviewers, and the severity of harm and preventability were assigned. The number of adverse events was then compared to internal incident reporting for the same time frame. ResultsThe detection rate is 4.87% within 411 patient-days. In contrast, the hospital had only 1.22% incident reports. ConclusionsThe GAPPS tool can detect four times more adverse events than the hospital incident reporting system. The results are likely to be replicated for other children's hospitals to increase identification of adverse events and harm to patients.

The SCOPE-PC instrument for assessing patient safety culture in primary care: a psychometric evaluation

Introduction: Primary healthcare differs from hospitals in terms of – inter alia – organisational structure. Therefore, patient safety culture could differ between these settings. Various instruments have been developed to measure collective attitudes of personnel within a primary healthcare organisation. However, the number of valid and reliable instruments is limited.Objectives: Psychometric properties of the SCOPE-Primary Care instrument were tested to examine the instrument’s applicability in home care services in Belgium.Methods: A cross-sectional study was conducted by administering the SCOPE-PC questionnaire in a single home care organisation with more than 1000 employees, including nurses, midwives, healthcare assistants, diabetes educators and nursing supervisors. First, a confirmatory factor analysis was performed to test whether the observed dataset fitted to the proposed seven-factor model of the SCOPE-PC instrument. Second, Cronbach’s alphas were calculated to examine internal consistency reliability. Finally, the instrument’s validity was also examined.Results: In total, 603 questionnaires were retained for further analysis, representing an overall response rate of 43.9%. Most respondents were nursing staff, followed by healthcare assistants and nursing supervisors. The results of the confirmatory factor analyses satisfied the chosen cut-offs, indicating an acceptable to good model fit. With the exception of the dimension ‘organizational learning’ (0.58), Cronbach’s alpha scores of the SCOPE-PC scales indicated a good level of internal consistency: ‘open communication and learning from error’ (0.86), ‘handover and teamwork’ (0.78), ‘adequate procedures and working conditions’ (0.73), ‘patient safety management’ (0.81), ‘support and fellowship’ (0.75), and ‘intention to report events (0.85). Moreover, inter-correlations between the seven dimensions as well as with the patient safety grade were moderate to good.Conclusions: The present study indicated that the SCOPE-Primary Care instrument has good psychometric properties for home care services in Belgium. No modifications are required to the original questionnaire in order to allow benchmarking between primary healthcare settings.