Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study

Hernan, Andrea L., Giles, Sally J., Fuller, Jeffrey, Johnson, Julie K., Walker, Christine and Dunbar, James A. 2015, Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study, BMJ quality and safety, vol. 24, no. 9, pp. 583-593, doi: 10.1136/bmjqs-2015-004049.

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Title Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study
Author(s) Hernan, Andrea L.ORCID iD for Hernan, Andrea L.
Giles, Sally J.
Fuller, Jeffrey
Johnson, Julie K.
Walker, Christine
Dunbar, James A.ORCID iD for Dunbar, James A.
Journal name BMJ quality and safety
Volume number 24
Issue number 9
Start page 583
End page 593
Total pages 11
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2015-09
ISSN 2044-5423
Keyword(s) Patient safety
Primary care
Qualitative research
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
Summary BACKGROUND: Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. METHODS: Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. RESULTS: Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. DISCUSSION: Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety.
Language eng
DOI 10.1136/bmjqs-2015-004049
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, BMJ Publishing Group
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Document type: Journal Article
Collections: Faculty of Health
Population Health
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