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Fiol-deRoque MA, Valderas JM, Arias de la Torre J, Serrano-Ripoll MJ, Gens-Barberà M, Sánchez-Freire E, Martín-Luján FM, Olry de Labry A, Ricci-Cabello I. Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire. Eur J Gen Pract 2024; 30:2296573. [PMID: 38197321 PMCID: PMC10783822 DOI: 10.1080/13814788.2023.2296573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notable exception to the scarcity of patient-reported patient safety measures. Full evaluation of their performance has only been attempted for the English version, thereby limiting its international applicability. OBJECTIVES To assess the psychometric performance of the Spanish and Catalan versions of the PREOS-PC-Compact. METHODS Cross-sectional validation study. We used Classical Test Theory methods to examine scale score distribution, internal consistency, and construct validity; and Item Response Theory (IRT) methods to further explore construct validity. RESULTS 3287 patients completed the Spanish version, and 1007 the Catalan version. Similar results were obtained for both versions. Confirmatory Factor Analysis supported a single construct for each scale. The correlations between PREOS-PC-Compact scales and known group analysis suggested adequate construct validity (inconclusive for known groups at the provider level). All four multi-item scales demonstrated adequate internal consistency reliability (α > 0.7), which was only confirmed for test-retest reliability for 'Practice activation.' A sample between 60-90 patients per practice was estimated sufficient to produce scores with reliability > 0.7 for all scales except for harm scales. IRT models showed disordered thresholds for 'Practice activation' and 'Harm burden' but showed excellent fit after reducing the response categories. CONCLUSION The Spanish and Catalan versions of the PREOS-PC-Compact are broadly valid and reliable tools to measure patient safety in Spanish primary care centres; confirmation of lower-than-expected test-rest reliability merits further examination .
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Affiliation(s)
- Maria A. Fiol-deRoque
- Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - José M. Valderas
- Centre for Research in Health Systems Performance, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Family Medicine, National University Health System, Singapore, Singapore
| | - Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- CIBER Biomedical Research Center in Epidemiology and Public Health (CIBERESP), Health Institute Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine, University of Leon, Leon, Spain
| | - Maria J. Serrano-Ripoll
- Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Montserrat Gens-Barberà
- Quality and Patient Safety Central Functional Unit, Gerència d‘Atenció Primària Camp de Tarragona, Catalan Institute of Health (ICS), Tarragona, Spain
- Research Group in Quality and Patient Safety, Institut Universitari d’Investigació en l’Atenció Primària-IDIAP Jordi Gol, Catalan Institute of Health (ICS), Tarragona, Spain
| | - Encarna Sánchez-Freire
- Quality and Patient Safety Unit, Gerència d‘Atenció Primària Catalunya Central, Catalan Institute of Health (ICS), Barcelona, Spain
| | - Francisco M. Martín-Luján
- Primary Healthcare Research Support Unit-Camp de Tarragona, Institut Universitari d’Investigació en l’Atenció Primària-IDIAP Jordi Gol, Catalan Institute of Health (ICS), Tarragona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), Reus, Spain
| | - Antonio Olry de Labry
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Research Group in Health and Gender, Andalusian School of Public Health, Granada, Spain
| | - Ignacio Ricci-Cabello
- Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Alaska YA, Alqahtani NM, Al Zahrani AK, Alshahri R, Malyani RZ, Alkutbe RB. Evaluating the content and face validity of Arabic-translated Patient Measures of Safety survey PMOS-30. PLoS One 2024; 19:e0304151. [PMID: 38870222 PMCID: PMC11175530 DOI: 10.1371/journal.pone.0304151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND The importance of patient perception of patient safety has been proven as an active role in promoting safety and predicting harm. Patients play a vital role in the healthcare sector and the impact of patient perception of patient safety has been repetitively proven in the literature to be for its effectiveness in predicting harm and promoting safety. Nonetheless, there is limited knowledge about the specific insights patients can provide concerning safety within Arab countries. Therefore, improving and strengthening active patient participation by including patients' perceptions of safety could offer novel contributions to the realm of patient safety. OBJECTIVE This study aims to evaluate the validity of the Arabic version of the PMOS-30. METHOD The forward-backward translation procedure was used to translate and validate the PMOS-30. Mix methods were used to assess the validity of the translated version. The expert raters evaluated the content validity and interviews were conducted with in-patients to assess the face validity. Test-retest approach was conducted to pilot the final Arabic version. RESULTS Data of face validity from 13 participants for the first test and 5 participants for the re-test was collected and showed an improvement in the clarity rate (71.50% and 94.66% respectively). With respect to the content validity of the final version, the CVI was 0.92, indicating excellent relevant results. CONCLUSION The final version of the revised was approved by the expert to be a valid tool to measure patient perceptions of patient safety in Arabic-speaking patients to be utilized on patient safety improvement initiatives.
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Affiliation(s)
- Yasser A. Alaska
- Technical Affair, Saudi Patient Safety Center (SPSC), Riyadh, Saudi Arabia
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nawaf M. Alqahtani
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amani K. Al Zahrani
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rawan Alshahri
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rana Z. Malyani
- Medical College, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rabab B. Alkutbe
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Louch G, Berzins K, Walker L, Wormald G, Blackwell K, Stephens M, Brown M, Baker J. Promoting a Patient-Centered Understanding of Safety in Acute Mental Health Wards: A User-Centered Design Approach to Develop a Real-Time Digital Monitoring Tool. JMIR Form Res 2024; 8:e53726. [PMID: 38607663 PMCID: PMC11053394 DOI: 10.2196/53726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Acute mental health services report high levels of safety incidents that involve both patients and staff. The potential for patients to be involved in interventions to improve safety within a mental health setting is acknowledged, and there is a need for interventions that proactively seek the patient perspective of safety. Digital technologies may offer opportunities to address this need. OBJECTIVE This research sought to design and develop a digital real-time monitoring tool (WardSonar) to collect and collate daily information from patients in acute mental health wards about their perceptions of safety. We present the design and development process and underpinning logic model and programme theory. METHODS The first stage involved a synthesis of the findings from a systematic review and evidence scan, interviews with patients (n=8) and health professionals (n=17), and stakeholder engagement. Cycles of design activities and discussion followed with patients, staff, and stakeholder groups, to design and develop the prototype tool. RESULTS We drew on patient safety theory and the concepts of contagion and milieu. The data synthesis, design, and development process resulted in three prototype components of the digital monitoring tool (WardSonar): (1) a patient recording interface that asks patients to input their perceptions into a tablet computer, to assess how the ward feels and whether the direction is changing, that is, "getting worse" or "getting better"; (2) a staff dashboard and functionality to interrogate the data at different levels; and (3) a public-facing ward interface. The technology is available as open-source code. CONCLUSIONS Recent patient safety policy and research priorities encourage innovative approaches to measuring and monitoring safety. We developed a digital real-time monitoring tool to collect information from patients in acute mental health wards about perceived safety, to support staff to respond and intervene to changes in the clinical environment more proactively.
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Affiliation(s)
- Gemma Louch
- School of Healthcare, University of Leeds, Leeds, United Kingdom
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, United Kingdom
| | - Kathryn Berzins
- Health Technology Assessment Unit, Applied Health Research Hub, Implementation and Capacity Building Team, NIHR Applied Research Collaboration North West Coast, University of Central Lancashire, Preston, United Kingdom
| | - Lauren Walker
- School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Gemma Wormald
- Thrive by Design, Leeds and York Partnership NHS Foundation Trust, Leeds, United Kingdom
| | - Kirstin Blackwell
- Thrive by Design, Leeds and York Partnership NHS Foundation Trust, Leeds, United Kingdom
| | | | - Mark Brown
- Social Spider CIC, London, United Kingdom
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, United Kingdom
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Goulding R, Birtwell K, Hann M, Peters S, van Marwijk H, Bower P. Safer Patients Empowered to Engage and Communicate about Health (SPEECH) in primary care: a feasibility study and process evaluation of an intervention for older people with multiple long-term conditions (multimorbidity). BMC PRIMARY CARE 2024; 25:12. [PMID: 38178010 PMCID: PMC10768368 DOI: 10.1186/s12875-023-02221-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Older people with multiple long-term conditions (multimorbidity) (MLTC-M) experience difficulties accessing and interacting with health and care services. Breakdowns in communication between patients and staff can threaten patient safety. To improve communication and reduce risks to patient safety in primary care, we developed an intervention: Safer Patients Empowered to Engage and Communicate about Health (SPEECH). SPEECH comprises a booklet for patients and an associated guide for staff. The booklet is designed to provide patients with information about staff and services, skills to prepare and explain, and confidence to speak up and ask. METHODS A single-arm mixed methods feasibility study with embedded process evaluation. General practices in the North West of England were recruited. Participating practices invited patients aged 65+ with MLTC-M who had an appointment scheduled during the study period. Patients were asked to complete questionnaires at baseline and follow-up (four to eight weeks after being sent the patient booklet), including the Consultation and Relational Empathy measure, Empowerment Scale, Multimorbidity Treatment Burden Questionnaire, and Primary Care Patient Measure of Safety. Staff completed questionnaires at the end of the study period. A sub-sample of patients and staff were interviewed about the study processes and intervention. Patients and the public were involved in all aspects of the study, from generation of the initial idea to interpretation of findings. RESULTS Our target of four general practices were recruited within 50 days of the study information being sent out. A fifth practice was recruited later to boost patient recruitment. We received expressions of interest from 55 patients (approx. 12% of those invited). Our target of 40 patient participants completed baseline questionnaires and were sent the SPEECH booklet. Of these, 38 (95%) completed follow-up. Patients found the intervention and study processes acceptable, and staff found the intervention acceptable and feasible to deliver. CONCLUSIONS Our findings suggest the intervention is acceptable, and it would be feasible to deliver a trial to assess effectiveness. Prior to further evaluation, study processes and the intervention will be updated to incorporate suggestions from participants. TRIAL REGISTRATION The study was registered on the ISRCTN registry (ISRCTN13196605: https://doi.org/10.1186/ISRCTN13196605 ).
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Affiliation(s)
- Rebecca Goulding
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England.
| | - Kelly Birtwell
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England.
| | - Mark Hann
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England
| | - Sarah Peters
- Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England
| | - Harm van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Watson Building, Brighton, England
| | - Peter Bower
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, England
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Tyler N, Planner C, Shears B, Hernan A, Panagioti M, Giles S. Developing the Resident Measure of Safety in Care Homes (RMOS): A Delphi and Think Aloud Study. Health Expect 2023; 26:1149-1158. [PMID: 36797827 PMCID: PMC10154851 DOI: 10.1111/hex.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE This study aimed to develop a measure of contributory factors to safety incidents in care homes to be completed by residents and/or their unpaid carers. INTRODUCTION Care home residents are particularly vulnerable to patient safety incidents, due to higher likelihood of frailty, multimorbidity and cognitive decline. However, despite residents and their carers wanting to be involved in safety initiatives, there are few mechanisms for them to contribute and make meaningful safety improvements to practice. METHODS We developed 73 evidence-based items from synthesis and existing measures, which we presented to a panel of stakeholders (residents/carers, health/social care professionals and researchers). We used two online rounds of Delphi to generate consensus (80%) on items important to include in the Resident Measure of Safety in Care Homes (RMOS); a consensus meeting was later held. The draft RMOS developed through the Delphi was presented to participants during 'Think Aloud' interviews using cognitive testing techniques. RESULTS The 29-item RMOS was developed. Forty-three participants completed Delphi round 1, and 27 participants completed round 2, 11 participants attended the consensus meeting and 12 'Think Aloud' interviews were conducted. Of the 73 original items, 42 items that did not meet consensus in Delphi round 1 were presented in round 2. After the consensus meeting, it was agreed that 35 items would comprise the RMOS questionnaire and were presented in the 'Think Aloud' interviews. Participants suggested numerous changes to items mostly to improve comprehension and ability to answer. CONCLUSION We have a developed an evidence-based RMOS, with good face validity, to assess contributory factors to safety in care homes from a resident/carer perspective. Future work will involve psychometrically testing the items in a pilot and developing a complementary simplified, dementia-friendly version to promote inclusivity. PATIENT OR PUBLIC INVOLVEMENT Four patient and public contributors worked with researchers to develop the online questionnaires. Patients (residents) and carers participated on the consensus panel. One member of the research team is an expert by lived experience and was involved in design and analysis decisions. The item list and instructions for the questionnaires were reviewed for face validity, understanding and acceptability by a patient and public involvement group and modified.
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Affiliation(s)
- Natasha Tyler
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,National Institute for Health and Care Research School for Primary Care Research, University of Manchester, Manchester, UK
| | - Claire Planner
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Bethany Shears
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Andrea Hernan
- Faculty of Health, Deakin University, Warrnambool, Australia
| | - Maria Panagioti
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,National Institute for Health and Care Research School for Primary Care Research, University of Manchester, Manchester, UK
| | - Sally Giles
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Barrow E, Lear RA, Morbi A, Long S, Darzi A, Mayer E, Archer S. How do hospital inpatients conceptualise patient safety? A qualitative interview study using constructivist grounded theory. BMJ Qual Saf 2022:bmjqs-2022-014695. [PMID: 36198506 DOI: 10.1136/bmjqs-2022-014695] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Efforts to involve patients in patient safety continue to revolve around professionally derived notions of minimising clinical risk, yet evidence suggests that patients hold perspectives on patient safety that are distinct from clinicians and academics. This study aims to understand how hospital inpatients across three different specialties conceptualise patient safety and develop a conceptual model that reflects their perspectives. METHODS A qualitative semi-structured interview study was conducted with 24 inpatients across three clinical specialties (medicine for the elderly, elective surgery and maternity) at a large central London teaching hospital. An abbreviated form of constructivist grounded theory was employed to analyse interview transcripts. Constant comparative analysis and memo-writing using the clustering technique were used to develop a model of how patients conceptualise patient safety. RESULTS While some patients described patient safety using terms consistent with clinical/academic definitions, patients predominantly conceptualised patient safety in the context of what made them 'feel safe'. Patients' feelings of safety arose from a range of care experiences involving specific actors: hospital staff, the patient, their friends/family/carers, and the healthcare organisation. Four types of experiences contributed to how patients conceptualise safety: actions observed by patients; actions received by patients; actions performed by patients themselves; and shared actions involving patients and other actors in their care. CONCLUSIONS Our findings support the need for a patient safety paradigm that is meaningful to all stakeholders, incorporating what matters to patients to feel safe in hospital. Additional work should explore and test how the proposed conceptual model can be practically applied and implemented to incorporate the patient conceptualisation of patient safety into everyday clinical practice.
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Affiliation(s)
- Emily Barrow
- NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Rachael A Lear
- NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Abigail Morbi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Susannah Long
- NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Ara Darzi
- NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Erik Mayer
- NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Stephanie Archer
- NIHR Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK .,Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
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Mao X, Zeng X, Zhong Q, Guo J. Translation and psychometric testing of the simplified version of the health-related diet and exercise self-efficacy scale in China. Health Qual Life Outcomes 2022; 20:127. [PMID: 36030253 PMCID: PMC9420267 DOI: 10.1186/s12955-022-02037-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Measuring health-related diet and exercise self-efficacy is an important first step in improving healthy behaviors and health outcomes. However, we did not find a self-efficacy measurement in Chinese that is specifically targeted at diet and exercise self-efficacy among healthy adults. Aim The present study aimed to translate the Health-Related Diet and Exercise Self-Efficacy Scale -simplified version into Mandarin Chinese (HRDESES) and evaluate its reliability and validity in Chinese healthy adults. Methods The HRDESES was translated and adapted to the Chinese context, with a good content validity of 0.86 among seven experts. The survey was then carried out in 216 adults in Hunan, China. Testing of the reliability included internal consistency reliability and test-retest reliability, while validity included content validity, construct validity, and criterion validity. Results The Cronbach's α of the HRDESES was 0.87 for the total scale, 0.86 for the diet subscale and 0.91 for the exercise subscale; the McDonald's ω of the HRDESES-SC was 0.85 for the total scale, 0.86 for the diet subscale and 0.91 for the exercise subscale, all demonstrating good internal consistency. The test-retest reliability was 0.88 for the total scale, 0.81 for the diet subscale and 0.82 for the exercise subscale, demonstrating good test-retest reliability. For construct validity, the scale effectively distinguished subjects by age, gender, education, occupation, marital status, and family income, showing good discriminant validity. The confirmatory factor analysis (CFA) supported a two-factor structure of the scale: diet and exercise subscale. It was demonstrated that the HRDESES was highly associated with the General Self-Efficacy Scale and its two subscales, with correlation coefficients ranging from 0.83 to 0.86 (p < 0.05), showing high criterion validity. Conclusion The HRDESES had good reliability and validity and could be used as a simple and effective tool for assessing the health-related diet and exercise self-efficacy in Chinese healthy adults.
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Affiliation(s)
- Xia Mao
- School of Nursing, Yueyang Vocational Technical College, Yueyang, 414000, Hunan, China
| | - Xuefang Zeng
- School of Nursing, Yueyang Vocational Technical College, Yueyang, 414000, Hunan, China
| | - Qinyi Zhong
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 414000, Hunan Province, China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 414000, Hunan Province, China.
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Stahl K, Reisinger A, Groene O. Assessing patient experience with patient safety in primary care: development and validation of the ASK-ME-questionnaire. BMJ Open 2022; 12:e049237. [PMID: 35387804 PMCID: PMC8987793 DOI: 10.1136/bmjopen-2021-049237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To develop and test the validity and reliability of a tool measuring patient experiences with patient safety in ambulatory care that is suitable for routine use in general practitioner and specialist practices. DESIGN Instrument development was based on a literature review, a 3-round Delphi survey with a multidisciplinary expert panel and cognitive interviews with patients. The instrument was piloted in 22 practices using a cross-sectional survey. Exploratory (EFA) and confirmatory factor analysis (CFA) were performed to test construct validity. Internal consistency and the ability of the questionnaire to differentiate between selected subgroups and at the level of individual practices was examined. SETTING General practitioner and specialist practices. PARTICIPANTS Patients aged >18 years seeking care in ambulatory care practices between February and June 2020. RESULTS The final ASK-ME-questionnaire consisted of 22 items covering 5 theoretical dimensions. A total of 3042 patients (71.1%) completed the questionnaire. Median item non-response rate was 4.2% (IQR 3.4%-4.7%). EFA yielded 3 factors comprising 14 items explaining 64.8% of the variance representing contributing factors to patient safety incidents. CFA confirmed the factorial structure suggested by EFA. The model fit the data satisfactorily (comparative fit index=0.92, root mean square error of approximation=0.08, standardised root mean square residual=0.08). Internal consistency values ranged from 0.7 to 0.9. Discriminant validity was supported by significant differences between patients of different age and differences in self-reported health status. The factors distinguished well between practices. CONCLUSION The ASK-ME-questionnaire showed good psychometric properties. It is suitable for routine use in patient safety measurement and improvement systems in ambulatory care. Further research is required to adequately assess number and type of experienced events in routine measurements.
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Affiliation(s)
- Katja Stahl
- Research & Innovation, Optimedis AG, Hamburg, Germany
- Midwifery Science, Universität zu Lübeck, Lubeck, Germany
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Shih C, Buchet-Poyau K, Keriel-Gascou M, Quenon JL, Michel P, Touzet S, Chanelière M. Culture de sécurité des professionnels de santé en soins primaires : adaptation en langue française du questionnaire MOSPSC (« Medical Office Survey on Patient Safety Culture »). Rev Epidemiol Sante Publique 2022; 70:51-58. [DOI: 10.1016/j.respe.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022] Open
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Madden C, Lydon S, O'Dowd E, Murphy AW, O'Connor P. A Systematic Review of Patient-Report Safety Climate Measures in Health Care. J Patient Saf 2022; 18:e51-e60. [PMID: 32345810 DOI: 10.1097/pts.0000000000000705] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Patients are a valuable, yet underutilized source of information for safety measurement and improvement in health care. The aim of this review was to identify patient-report safety climate (SC) measures described in the literature, analyze the included items to consider their alignment with previously established SC domains, evaluate their validity and reliability, and make recommendations for best practice in using patient-report measures of SC in health care. METHODS Searches were conducted, with no limit on publication year, using MEDLINE, EMBASE, CINAHL, PsycINFO, and Academic Search Complete in November 2019. Reference lists of included studies and existing reviews were also screened. English-language, peer-reviewed studies that described the development or use of a patient-report measure to assess SC in health care were included. Two researchers independently extracted data from studies and applied a quality appraisal tool. RESULTS A total of 5060 studies were screened, with 44 included. Included studies described 31 different SC measures. There was much variability in the coverage of SC domains across included measures. Poor measure quality was marked by inadequacies in the testing and reporting of validity and reliability. There was also a lack of usability testing among measures. CONCLUSIONS This review identified the extant patient-reported SC measures in health care and demonstrated significant variance in their coverage of SC domains, validity and reliability, and usability. Findings suggest a pressing need for a stand-alone measure that has a high validity and reliability, and assess core SC domains from the patient perspective, particularly in primary care.
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Gens-Barberà M, Hernández-Vidal N, Castro-Muniain C, Hospital-Guardiola I, Oya-Girona EM, Bejarano-Romero F, Rey-Reñones C, Martín-Luján F. [Patient safety incidents reported before and after the start of the COVID-19 pandemic in Primary Care in Tarragona]. Aten Primaria 2021; 53 Suppl 1:102217. [PMID: 34961580 PMCID: PMC8708815 DOI: 10.1016/j.aprim.2021.102217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
Objetivo Analizar y comparar la epidemiologia de los incidentes de seguridad del paciente notificados en centros de atención primaria, antes y después del inicio de la pandemia COVID-19. Diseño y emplazamiento Estudio descriptivo analítico comparando los incidentes notificados del 01-marzo-2019 al 28-febrero-2020, y del 01-marzo-2020 al 28-febrero-2021, realizados a través de la plataforma TPSC Cloud™ accesible desde la Intranet corporativa en 25 centros de atención primaria del distrito de Tarragona, Cataluña, España. Mediciones Registros obtenidos a partir de notificaciones voluntarias mediante formulario electrónico, estandarizado y anonimizado. Variables: centro sanitario, profesional, tipo de incidente, matriz de riesgo, factores causales, contribuyentes y evitabilidad. Análisis estadístico: Se realizó análisis descriptivo del total de notificaciones y otro específico de los eventos adversos, comparando ambos períodos. Resultados Se notificaron un total de 2.231 incidentes. Comparando ambos períodos, en el de pandemia se observó una reducción del número de incidentes notificados (solo representaron un 20% del total), pero en proporción se incrementó el porcentaje de notificaciones por parte de profesionales sanitarios y el de eventos adversos que requirieron observación. También aumentaron los factores causales relacionados con los cuidados y el diagnóstico, y disminuyeron los de medicación. Además, se observó un incremento de los factores contribuyentes relacionados con el profesional. La evitabilidad fue elevada (>95%) en ambos períodos. Conclusiones Durante la pandemia, se han notificado un menor número de incidentes de seguridad del paciente, pero en proporción, más eventos adversos, siendo en su mayoría evitables. El propio profesional se convierte en el principal factor contribuyente.
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Affiliation(s)
- Montserrat Gens-Barberà
- Unidad de Calidad y Seguridad del Paciente, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España.
| | - Núria Hernández-Vidal
- Unidad de Calidad y Seguridad del Paciente, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España
| | - Carles Castro-Muniain
- Unidad de Calidad y Seguridad del Paciente, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España
| | - Inmaculada Hospital-Guardiola
- Unidad de Calidad y Seguridad del Paciente, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España; Centro de Atención Primaria Dr. Turró, Valls, Direcció d'Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, España
| | - Eva Maria Oya-Girona
- Unidad de Calidad y Seguridad del Paciente, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España; Centre d'Alta Resolució, Salou, Direcció d'Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, España
| | - Ferran Bejarano-Romero
- Unidad de Calidad y Seguridad del Paciente, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España
| | - Cristina Rey-Reñones
- Unitat de Suport a la Recerca Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España; Facultad de Medicina y Ciencias de la Salud, Universitat Rovira i Virgili, Tarragona, España
| | - Francisco Martín-Luján
- Unitat de Suport a la Recerca Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España; Facultad de Medicina y Ciencias de la Salud, Universitat Rovira i Virgili, Tarragona, España
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Stahl K, Groene O. ASK ME!-Routine measurement of patient experience with patient safety in ambulatory care: A mixed-mode survey. PLoS One 2021; 16:e0259252. [PMID: 34851966 PMCID: PMC8635405 DOI: 10.1371/journal.pone.0259252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 10/15/2021] [Indexed: 11/19/2022] Open
Abstract
Objective Routine measurement of patient safety from the patients’ perspective receives increasing attention as an important component of safety measurement systems. The aim of this study was to examine patients’ experience with patient safety in ambulatory care and the results’ implications for routine patient safety measurement in ambulatory care. Design Cross-sectional mixed-mode survey. Setting General practitioner and specialist practices. Participants Patients aged >18 years seeking care in ambulatory care practices between February and June 2020. Methods A 22-item-questionnaire was completed in the practice or at home either on paper or online. Multivariate logistic regression was used to analyse the influence of survey mode and patient characteristics on patient experience with patient safety. Results The overall response rate was 71.1%. Most patients completed the questionnaire on site (76.6%) and on paper (96.1%). Between 30.1% to 68.5% of the respondents report the most positive option for patient experience with the main domains of patient safety. A total of 2.9% of patients reported having experienced a patient-safety event (PSE) during the last 12 months. Patients who filled in the questionnaire off site were more likely to report negative experiences for the scales communication & information (OR 1.2, 95% CI 1.0–1.5), rapport & participation (OR 1.4, 95% CI 1.1–1.7) and access (OR 1.3, 95% CI 0.9–1.4) than those who completed it on site. Those who chose a paper questionnaire were more likely to report negative experiences for all five scales compared to web responders. Conclusion Routine measurement of patient experience with factors contributing to the occurrence of PSEs can achieve high response rates by offering flexible participation options. Results gained from mixed-mode surveys need to take mode-effects into account when interpreting and using the results. Further research is needed in how to adequately assess number and type of experienced events in routine measurements.
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Affiliation(s)
- Katja Stahl
- Department Research & Innovation, OptiMedis AG, Hamburg, Germany
- * E-mail:
| | - Oliver Groene
- Department Research & Innovation, OptiMedis AG, Hamburg, Germany
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Gens-Barberà M, Hernández-Vidal N, Vidal-Esteve E, Mengíbar-García Y, Hospital-Guardiola I, Oya-Girona EM, Bejarano-Romero F, Castro-Muniain C, Satué-Gracia EM, Rey-Reñones C, Martín-Luján FM. Analysis of Patient Safety Incidents in Primary Care Reported in an Electronic Registry Application. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8941. [PMID: 34501530 PMCID: PMC8430626 DOI: 10.3390/ijerph18178941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES (1) To describe the epidemiology of patient safety (PS) incidents registered in an electronic notification system in primary care (PC) health centres; (2) to define a risk map; and (3) to identify the critical areas where intervention is needed. DESIGN Descriptive analytical study of incidents reported from 1 January to 31 December 2018, on the TPSC Cloud™ platform (The Patient Safety Company) accessible from the corporate website (Intranet) of the regional public health service. SETTING 24 Catalan Institute of Health PC health centres of the Tarragona region (Spain). PARTICIPANTS Professionals from the PC health centres and a Patient Safety Functional Unit. MEASUREMENTS Data obtained from records voluntarily submitted to an electronic, standardised and anonymised form. Data recorded: healthcare unit, notifier, type of incident, risk matrix, causal and contributing factors, preventability, level of resolution and improvement actions. RESULTS A total of 1544 reports were reviewed and 1129 PS incidents were analysed: 25.0% of incidents did not reach the patient; 66.5% reached the patient without causing harm, and 8.5% caused adverse events. Nurses provided half of the reports (48.5%), while doctors reported more adverse events (70.8%; p < 0.01). Of the 96 adverse events, 46.9% only required observation, 34.4% caused temporary damage that required treatment, 13.5% required (or prolonged) hospitalization, and 5.2% caused severe permanent damage and/or a situation close to death. Notably, 99.2% were considered preventable. The main critical areas were: communication (27.8%), clinical-administrative management (25.1%), care delivery (23.5%) and medicines (18.4%); few incidents were related to diagnosis (3.6%). CONCLUSIONS PS incident notification applications are adequate for reporting incidents and adverse events associated with healthcare. Approximately 75% and 10% of incidents reach the patient and cause some damage, respectively, and most cases are considered preventable. Adequate and strengthened risk management of critical areas is required to improve PS.
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Affiliation(s)
- Montserrat Gens-Barberà
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Núria Hernández-Vidal
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Elisa Vidal-Esteve
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Yolanda Mengíbar-García
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Immaculada Hospital-Guardiola
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
- Primary Health-Care Centre, Institut Català de la Salut, 43005 Tarragona, Spain
| | - Eva M. Oya-Girona
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
- Primary Health-Care Centre, Institut Català de la Salut, 43005 Tarragona, Spain
| | - Ferran Bejarano-Romero
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
- Pharmacy Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain
| | - Carles Castro-Muniain
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Eva M. Satué-Gracia
- Research Support Unit Tarragona-Reus, Institut Universitari D’investigació en L’atenció Primària Jordi Gol, (IDIAP Jordi Gol), Institut Català de la Salut, 43202 Reus, Spain; (E.M.S.-G.); (C.R.-R.); (F.M.M.-L.)
| | - Cristina Rey-Reñones
- Research Support Unit Tarragona-Reus, Institut Universitari D’investigació en L’atenció Primària Jordi Gol, (IDIAP Jordi Gol), Institut Català de la Salut, 43202 Reus, Spain; (E.M.S.-G.); (C.R.-R.); (F.M.M.-L.)
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Francisco M. Martín-Luján
- Research Support Unit Tarragona-Reus, Institut Universitari D’investigació en L’atenció Primària Jordi Gol, (IDIAP Jordi Gol), Institut Català de la Salut, 43202 Reus, Spain; (E.M.S.-G.); (C.R.-R.); (F.M.M.-L.)
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
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Effectiveness of New Tools to Define an Up-to-Date Patient Safety Risk Map: A Primary Care Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168612. [PMID: 34444360 PMCID: PMC8392165 DOI: 10.3390/ijerph18168612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022]
Abstract
Background: Reducing incidents related to health care interventions to improve patient safety is a health policy priority. To strengthen a culture of safety, reporting incidents is essential. This study aims to define a patient safety risk map using the description and analysis of incidents within a primary care region with a prior patient safety improvement strategy organisationally developed and promoted. Methods: The study will be conducted in two phases: (1) a cross-sectional descriptive observational study to describe reported incidents; and (2) a quasi-experimental study to compare reported incidents. The study will take place in the Camp de Tarragona Primary Care Management (Catalan Institute of Health). In Phase 1, all reactive notifications collected within one year (2018) will be analysed; during Phase 2, all proactive notifications of the second and third weeks of June 2019 will be analysed. Adverse events will also be assessed. Phases 1 and 2 will use a digital platform and the proactive tool proSP to notify and analyse incidents related to patient safety. Expected Results: To obtain an up-to-date, primary care patient safety risk map to prioritise strategies that result in safer practices.
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Adie K, Fois RA, McLachlan AJ, Walpola RL, Chen TF. The nature, severity and causes of medication incidents from an Australian community pharmacy incident reporting system: The QUMwatch study. Br J Clin Pharmacol 2021; 87:4809-4822. [PMID: 34022060 DOI: 10.1111/bcp.14924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 12/01/2022] Open
Abstract
AIMS Most research into medication safety has been conducted in hospital settings with less known about primary care. The aim of this study was to characterise the nature and causes of medication incidents (MIs) in the community using a pharmacy incident reporting programme. METHODS Thirty community pharmacies participated in an anonymous or confidential MI spontaneous reporting programme in Sydney, Australia. The Advanced Incident Management System was used to record and classify incident characteristics, contributing factors, severity and frequency ratings. RESULTS In total, 1013 incidents were reported over 30 months, 831 of which were near misses while 165 reports involved patient harm. The largest proportion of cases pertained to patients aged >65 years (35.7%). Most incidents involved errors during the prescribing stage (61.1%), followed by dispensing (25.7%) and administration (23.5%), while some errors occurred at multiple stages (17.9%). Systemic antibacterials (12.2%), analgesics (11.8%) and renin-angiotensin medicines (11.7%) formed the majority of implicated classes. Participants identified diverse and interrelating contributing factors: those concerning healthcare providers included violations to procedures/guidelines (75.6%), rule-based mistakes (55.6%) and communication (50.6%); those concerning patients included cognitive factors (31.9%), communication (25.5%) and behaviour (6.1%). Organisational safety culture and inadequate risk management processes were rated as suboptimal. CONCLUSION An MI reporting programme can capture and characterise medication safety problems in the community and identify the human and system factors that contribute to errors. Since medicine use is ubiquitous in the community, morbidity and mortality from MIs may be reduced by addressing the prioritised risks and contributing factors identified in this study.
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Affiliation(s)
- Khaled Adie
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Romano A Fois
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew J McLachlan
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ramesh L Walpola
- School of Public Health and Community Medicine, Sydney, Australia
| | - Timothy F Chen
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Hernan AL, Giles SJ, Carson-Stevens A, Morgan M, Lewis P, Hind J, Versace V. Nature and type of patient-reported safety incidents in primary care: cross-sectional survey of patients from Australia and England. BMJ Open 2021; 11:e042551. [PMID: 33926976 PMCID: PMC8094340 DOI: 10.1136/bmjopen-2020-042551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 02/08/2021] [Accepted: 04/01/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Patient engagement in safety has shown positive effects in preventing or reducing adverse events and potential safety risks. Capturing and utilising patient-reported safety incident data can be used for service learning and improvement. OBJECTIVE The aim of this study was to characterise the nature of patient-reported safety incidents in primary care. DESIGN Secondary analysis of two cross sectional studies. PARTICIPANTS Adult patients from Australian and English primary care settings. MEASURES Patients' self-reported experiences of safety incidents were captured using the validated Primary Care Patient Measure of Safety questionnaire. Qualitative responses to survey items were analysed and categorised using the Primary Care Patient Safety Classification System. The frequency and type of safety incidents, contributory factors, and patient and system level outcomes are presented. RESULTS A total of 1329 patients (n=490, England; n=839, Australia) completed the questionnaire. Overall, 5.3% (n=69) of patients reported a safety incident over the preceding 12 months. The most common incident types were administration incidents (n=27, 31%) (mainly delays in accessing a physician) and incidents involving diagnosis and assessment (n=16, 18.4%). Organisation of care accounted for 27.6% (n=29) of the contributory factors identified in the safety incidents. Staff factors (n=13, 12.4%) was the second most commonly reported contributory factor. Where an outcome could be determined, patient inconvenience (n=24, 28.6%) and clinical harm (n=21, 25%) (psychological distress and unpleasant experience) were the most frequent. CONCLUSIONS The nature and outcomes of patient-reported incidents differ markedly from those identified in studies of staff-reported incidents. The findings from this study emphasise the importance of capturing patient-reported safety incidents in the primary care setting. The patient perspective can complement existing sources of safety intelligence with the potential for service improvement.
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Affiliation(s)
- Andrea L Hernan
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Geelong, Victoria, Australia
| | - Sally J Giles
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Andrew Carson-Stevens
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
- Australian Institute of Health Innovation, Sydney, New South Wales, Australia
| | - Mark Morgan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Penny Lewis
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - James Hind
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Vincent Versace
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Geelong, Victoria, Australia
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Cheng S, Hu Y, Pfaff H, Lu C, Fu Q, Wang L, Li D, Xia S. The Patient Safety Culture Scale for Chinese Primary Health Care Institutions: Development, Validity and Reliability. J Patient Saf 2021; 17:114-121. [PMID: 32404850 PMCID: PMC7908859 DOI: 10.1097/pts.0000000000000733] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Existing patient safety culture assessment tools are mostly developed in western countries and may not be suitable for Chinese primary health care institutions. Primary care plays an important role in China's medical system, and a targeted tool for its patient safety culture is urgently needed. OBJECTIVE The aim of the study was to develop a dependable instrument to assess the patient safety culture in Chinese primary health care institutions. METHODS Three phases were undertaken to develop the scale. The first phase developed a pilot scale by literature review, focus groups, and 2-round Delphi expert consultation. The second phase conducted a pilot survey. The third phase carried out a formal survey to test reliability and validity, involving 369 participants from 9 primary health care institutions. RESULTS The final scale included 32 items under 7 dimensions. For reliability, the Cronbach α coefficients among dimensions varied from 0.754 to 0.926, and the Cronbach α for the scale was 0.940. For content validity, the corrected item-level content validity varied between 0.64 and 1, the scale-level content validity index/universal agreement was 0.625, and the scale-level content validity index/average was 0.93. For construct validity, the Spearman correlations of dimension-total score varied between 0.129 and 0.851, all Spearman correlations of the dimension-total score were greater than that of interdimensions and the Spearman correlations of item-total score ranged from 0.042 to 0.775. The results of the confirmatory factor analysis indicated that the model fitted well. CONCLUSIONS The Patient Safety Culture Scale for Chinese primary health care institutions demonstrated good reliability and acceptable validity; thus, it can be used as an assessment instrument for patient safety culture in Chinese primary health care institutions.
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Affiliation(s)
- Siyu Cheng
- From the School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yinhuan Hu
- From the School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Holger Pfaff
- Center for Health Services Research Cologne, University of Cologne, Cologne, Germany
| | - Chuntao Lu
- Jingmen No. 2 People's Hospital, Jingmen, Hubei, PR China
| | - Qiang Fu
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - Liuming Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Dehe Li
- From the School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shixiao Xia
- From the School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
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Qu J, Zhu Y, Cui L, Yang L, Lai Y, Ye X, Qu B. Psychometric properties of the Chinese version of the TeamSTEPPS teamwork perceptions questionnaire to measure teamwork perceptions of Chinese residents: a cross-sectional study. BMJ Open 2020; 10:e039566. [PMID: 33191259 PMCID: PMC7668380 DOI: 10.1136/bmjopen-2020-039566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The purpose of this research was to evaluate the psychometric properties of the TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ) among the Chinese residents. DESIGN Cross-sectional study. SETTING A clinical hospital of the China Medical University in Liaoning Province, China. PARTICIPANTS A total of 664 residents were enrolled in this research. The valid response rate was 83.0% (664 of 800 residents). MAIN OUTCOME MEASURES Internal consistency and test-retest reliability were used to assess the reliability of the questionnaire. The construct validity of the Chinese T-TPQ was evaluated by confirmatory factor analysis. Furthermore, the concurrent, convergent and discriminant validity were analysed. RESULTS Cronbach's α coefficient of the T-TPQ in Chinese language was 0.923. Except for the communication dimension (0.649), the Cronbach's α coefficient of all dimensions were satisfactory. The T-TPQ and its five dimensions reported a good test-retest reliability (0.740-0.881, p<0.01). Moreover, the results of the confirmatory factor analysis demonstrated that the construct validity of the Chinese T-TPQ was satisfactory. All dimensions significantly correlated with the Hospital Survey on Patient Safety Culture (HSOPSC) teamwork within units dimension and the Safety Attitudes Questionnaire (SAQ) teamwork climate dimension (p<0.01), and the questionnaire showed satisfactory convergent and discriminant validity. CONCLUSIONS The T-TPQ in Chinese language demonstrated good psychometric characteristics and was a reliable and valid questionnaire to measure the Chinese health professionals' perception of teamwork. Thus, the Chinese version of the T-TPQ could be applied in teamwork training programmes and medical education research.
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Affiliation(s)
- Jinglou Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
- Department of Postgraduate Administration, The First Hospital of China Medical University, Shenyang, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Liyuan Cui
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
- China Medical University Library, China Medical University, Shenyang, China
| | - Libin Yang
- Center for Higher Education Research and Teaching Quality Evaluation, Harbin Medical University, Harbin, China
| | - Yanni Lai
- Medical Education Office, Fudan University, Shanghai, China
| | - Xuechen Ye
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Bo Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
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Pohlman KA, Salsbury SA, Funabashi M, Holmes MM, Mior S. Patient safety in chiropractic teaching programs: a mixed methods study. Chiropr Man Therap 2020; 28:50. [PMID: 32943068 PMCID: PMC7500017 DOI: 10.1186/s12998-020-00339-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background Patient safety research has lagged within academic settings, including chiropractic teaching institutions. To develop a robust patient safety culture, the Institute of Medicine emphasized the need for employee’s attitudes to be understanding and positive. To initiate the assessment of the current culture and future needs, this study evaluated patient safety attitudes among chiropractic teaching clinic stakeholders (supervising clinicians, student interns, and administrative staff) and compared their standardized survey scores to established medical survey databases. Methods We conducted a cross-sectional, mixed methods survey design with quantitative analytic priority. Chiropractic interns, clinical faculty, and clinic staff of 5 international chiropractic educational programs completed a modified version of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Culture for Medical Offices Survey with open-ended comment fields between 2014 and 2016. Composite means of positive responses were calculated and compared to patient safety, quality of care, and overall self-ratings benchmarks from Canadian providers and academic settings in the AHRQ database. Qualitative responses were thematically categorized for a convergent analysis of quantitative results for the chiropractic sample. Results Chiropractic survey response rate was 45.3% (n = 645). Quantitative survey results indicated moderate scores and ranges (57–85%) on all patient safety dimensions for the chiropractic samples. Academic medicine and chiropractic providers’ benchmarks scored higher positive responses than chiropractic teaching clinics on most quantitative dimensions, except for work pressure/pace. Teamwork, organizational learning, and patient tracking/follow-up were the most positively endorsed quantitative dimensions, with communication, staff training, office standardization, and leadership support considered areas for improvement in both settings. Qualitative responses for the chiropractic clinics identified a need for open communication; additional staff training and student involvement in creating safety cultures; standardization of office processes including information exchange, scheduling, and equipment maintenance; and leadership support that focused on decreasing work pressure/pace and setting safety priorities. Conclusion As the first report of patient safety attitudes from stakeholders in chiropractic teaching clinics, specific areas of improvement were identified. Chiropractic teaching programs might consider incorporating these and related patient safety concepts into their formal curricula. Mixed methods approach offers teaching clinics opportunities to assess stakeholders’ insights and enhance safe delivery of chiropractic care.
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Affiliation(s)
| | - Stacie A Salsbury
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 1000 Brady St, Davenport, IA, 52803, USA
| | - Martha Funabashi
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - Michelle M Holmes
- AECC University College, Parkwood Campus, Parkwood Rd, Bournemouth, BH5 2DF, UK
| | - Silvano Mior
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
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Hernan AL, Giles SJ, Beks H, McNamara K, Kloot K, Binder MJ, Versace V. Patient feedback for safety improvement in primary care: results from a feasibility study. BMJ Open 2020; 10:e037887. [PMID: 32565479 PMCID: PMC7307531 DOI: 10.1136/bmjopen-2020-037887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/05/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Patient involvement in safety improvement is a developing area of research. The aim of this study was to investigate the feasibility of a patient feedback on safety intervention in primary care. Specifically, the intervention acceptability, fidelity, implementation enablers and barriers, scalability, and process of systematically collecting safety data were examined. DESIGN, SETTING AND PARTICIPANTS Mixed-methods feasibility trial with six purposively selected Australian primary care practices. INTERVENTION The intervention comprised an iterative process with a cycle of measurement, learning, feedback, action planning and implementation period of 6 months. PRIMARY AND SECONDARY OUTCOMES Qualitative and quantitative data relating to feasibility measures (acceptability, fidelity, enablers, barriers, scalability and process of collecting safety data) were collected and analysed. RESULTS A total of n=1750 patients provided feedback on safety. There was a statistically significant increase in mean patient safety scores indicating improved safety (4.30-4.37, p=0.002). Staff deemed the intervention acceptable, with minor recommendations for improvement. Intervention fidelity was high and implementation enablers were attributed to the intervention structure and framework, use of intuitive problem-solving approaches, and multidisciplinary team involvement. Practice-based safety interventions resulted in sustainable and measurable changes to systems for safety, such as increased access to care and improved patient information accuracy. CONCLUSIONS The findings indicate that this innovative patient feedback on safety intervention is feasible for scale-up to a larger effectiveness trial and further spread into policy and practice. This intervention complements existing safety improvement strategies and activities, and integrates into current patient feedback service requirements for Australian primary care. Further research is needed to examine the intervention effects on safety incident reduction.
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Affiliation(s)
- Andrea L Hernan
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
| | - Sally J Giles
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Hannah Beks
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
| | - Kevin McNamara
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
| | - Kate Kloot
- Centre for Rural Emergency Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Marley J Binder
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
| | - Vincent Versace
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
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21
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Hernández Vidal N, Satué Gracia EM, Basora Gallisà J, Flores Mateo G, Gens Barberà M. [Translation, adaptation and validation in Catalan of a questionnaire about patient safety culture: The MOSPSC (Medical Office Survey on Patient Safety Culture) questionnaire]. J Healthc Qual Res 2019; 34:248-257. [PMID: 31713521 DOI: 10.1016/j.jhqr.2019.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 05/03/2019] [Accepted: 05/16/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Patient safety is an essential dimension of quality of care and a priority in health policies. The diffusion of the security culture is a key strategy and the questionnaire MOSPSC (Medical Office Survey on Patient Safety Culture), in its English and Spanish versions, has proved to be a good instrument to 'measure it'. The aim of this work is to translate, adapt and validate the questionnaire in Catalan. MATERIAL AND METHODS Translation, retrotranslation and adaptation of MOSPSC questionnaire of the AHRQ (Agency for Healthcare Research and Quality). Reliability and validity analysis of the adapted questionnaire. RESULTS It is a simple, well accepted and valued questionnaire, although extensive. Catalan version facilitates more precise comprehension and improves completion. We found small response percentages 'do not apply or do not know' in questions from Section F (At the Center) but notable in some questions referred to specific professional staff. For most items show suitable discrimination rates and both the complete questionnaire and subscales extracted after factor analysis obtain good reliability indexes. CONCLUSIONS Final version, very similar to original and Spanish adapted, will allow comparisons as well as monitoring/follow-up after implementation of improvement strategies. Due to its length, it could be assessed using only related dimensions.
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Affiliation(s)
- N Hernández Vidal
- Unidad de Calidad Territorial, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España
| | - E M Satué Gracia
- Unidad de Soporte a la Investigación Camp de Tarragona-Reus, Dirección de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, España; Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Barcelona, España.
| | - J Basora Gallisà
- Unidad de Soporte a la Investigación Camp de Tarragona-Reus, Dirección de Atención Primaria Camp de Tarragona, Institut Català de la Salut, Tarragona, España; Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Barcelona, España
| | - G Flores Mateo
- Xarxa Sanitària i Social Santa Tecla, Tarragona, España; Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Barcelona, España
| | - M Gens Barberà
- Unidad de Calidad Territorial, Gerencia Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, España
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Hernan AL, Kloot K, Giles SJ, Beks H, McNamara K, Binder MJ, Versace V. Investigating the feasibility of a patient feedback tool to improve safety in Australian primary care: a study protocol. BMJ Open 2019; 9:e027327. [PMID: 31061052 PMCID: PMC6501999 DOI: 10.1136/bmjopen-2018-027327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/16/2019] [Accepted: 03/21/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Patients are a valuable source of information about ways to prevent harm in healthcare, and can provide feedback about the factors that contribute to safety incidents. The Primary Care Patient Measure of Safety (PC PMOS) is a novel and validated tool that captures patient feedback on safety and can be used by primary care practice teams to identify and prevent safety incidents. The aim of this study is to assess the feasibility of PC PMOS as a tool for data-driven safety improvement and monitoring in Australian primary care. METHODS AND ANALYSIS Feasibility will be assessed using a mixed-methods approach to understand the enablers, barriers, acceptability, practicability, intervention fidelity and scalability of C PMOS as a tool for safety improvement across six primary care practices in the south-west region of Victoria. Patients over the age of 18 years attending their primary care practice will be invited to complete the PC PMOS when presenting for an appointment. Staff members at each practice will form a safety improvement team. Staff will then use the patient feedback to develop and implement specific safety interventions over a 6-month period. Data collection methods during the intervention period includes audio recordings of staff meetings, overt observations at training and education workshops, reflexive researcher insights, document collection and review. Data collection postintervention includes patient completion of the PC PMOS and semistructured interviews with staff. Triangulation and thematic analysis techniques will be employed to analyse the qualitative and content data. Analysis methods will use current evidence and models of healthcare culture, safety improvement and patient involvement in safety to inform the findings. ETHICS AND DISSEMINATION Ethics approval was granted by Deakin University Human Ethics Advisory Group, Faculty of Health (HEAG-H 175_2017). Study results will be disseminated through local and international conferences and peer-reviewed publications.
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Affiliation(s)
- Andrea L Hernan
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Kate Kloot
- Centre for Rural Emergency Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Sally J Giles
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Hannah Beks
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Kevin McNamara
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Marley J Binder
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vincent Versace
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
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