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Influences on the adoption of patient safety innovation in primary care : a qualitative exploration of staff perspectives

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Litchfield, Ian, Gill, Paramjit, Avery, Tony, Campbell, Stephen, Perryman, Katherine, Marsden, Kate and Greenfield, Sheila (2018) Influences on the adoption of patient safety innovation in primary care : a qualitative exploration of staff perspectives. BMC Family Practice, 19 (1). 72. doi:10.1186/s12875-018-0761-2 ISSN 1471-2296.

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Official URL: http://dx.doi.org/10.1186/s12875-018-0761-2

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Abstract

Background

Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing complexity of patients and their care. One such intervention is the multi-strand, single platform, Patient Safety Toolkit developed to help practices provide safer care in this dynamic and pressured environment where the likelihood of adverse incidents is increasing. Here we describe the attitudes of staff toward these tools and how their implementation was shaped by a number of contextual factors specific to each practice.

Methods

The Patient Safety Toolkit comprised six tools; a system of rapid note review, an online staff survey, a patient safety questionnaire, prescribing safety indicators, a medicines reconciliation tool, and a safe systems checklist. We implemented these tools at practices across the Midlands, the North West, and the South Coast of England and conducted semi-structured interviews to determine staff perspectives on their effectiveness and applicability.

Results

The Toolkit was used in 46 practices and a total of 39 follow-up interviews were conducted. Three key influences emerged on the implementation of the Toolkit these related to their ease of use and the novelty of the information they provide; whether their implementation required additional staff training or practice resource; and finally factors specific to the practice’s local environment such as overlapping initiatives orchestrated by their CCG.

Conclusions

The concept of a balanced toolkit to address a range of safety issues proved popular. A number of barriers and facilitators emerged in particular those tools that provided relevant information with a minimum impact on practice resource were favoured. Individual practice circumstances also played a role. Practices with IT aware staff were at an advantage and those previously utilising patient safety initiatives were less likely to adopt additional tools with overlapping outputs. By acknowledging these influences we can better interpret reaction to and adoption of individual elements of the toolkit and optimise future implementation.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Primary health care -- Safety measures, Physicians (General practice), Aging -- Health aspects
Journal or Publication Title: BMC Family Practice
Publisher: BioMed Central Ltd.
ISSN: 1471-2296
Official Date: December 2018
Dates:
DateEvent
December 2018Published
22 May 2018Available
2 May 2018Accepted
Volume: 19
Number: 1
Article Number: 72
DOI: 10.1186/s12875-018-0761-2
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 23 May 2018
Date of first compliant Open Access: 23 May 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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