'The big buzz': a qualitative study of how safe care is perceived, understood and improved in general practice

de Wet, C., Bowie, P. and O'Donnell, C. (2018) 'The big buzz': a qualitative study of how safe care is perceived, understood and improved in general practice. BMC Family Practice, 19(1), 83. (doi: 10.1186/s12875-018-0772-z) (PMID:29885654) (PMCID:PMC5994252)

Abstract

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

• Item Type: Articles
• Additional Information: Two of the authors (CdW and PB) were salaried employees of NHS Education for Scotland (NES). NES provided funding for the professional fees that were provided to participating practices and a nVivo licence.
• Keywords: Family medicine, general practice, patient safety, patient safety incidents, quality improvement.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: De Wet, Carl and O'Donnell, Professor Kate and Bowie, Dr Paul
• Authors: de Wet, C., Bowie, P., and O'Donnell, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: BMC Family Practice
• Publisher: BioMed Central
• ISSN: 1471-2296
• ISSN (Online): 1471-2296
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in BMC Family Practice 19(1):83
• Publisher Policy: Reproduced under a Creative Commons License