A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice

Andrew Carson-Stevens¹, Peter Hibbert², Anthony Avery³, Amy Butlin⁴, Ben Carter⁴, Alison Cooper⁴, Huw Prosser Evans⁴, Russell Gibson⁴, Donna Luff⁵, Meredith Makeham⁶, Paul McEnhill⁴, Sukhmeet S Panesar⁷, Gareth Parry⁸, Philippa Rees⁴, Emma Shiels⁴, Aziz Sheikh⁹, Hope Olivia Ward⁴, Huw Williams⁴, Fiona Wood⁴, Liam Donaldson¹⁰, Adrian Edwards⁴

Affiliations

¹ Primary Care Patient Safety (PISA) Research Group, Primary and Emergency Care Research (PRIME) Centre Wales, School of Medicine, Cardiff University, Wales, UK Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK.
² Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia Australian Patient Safety Foundation, Adelaide, Australia.
³ Division of General Practice, College of Community Health Sciences, University of Nottingham, Nottingham, UK.
⁴ Primary Care Patient Safety (PISA) Research Group, Primary and Emergency Care Research (PRIME) Centre Wales, School of Medicine, Cardiff University, Wales, UK.
⁵ Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA.
⁶ Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
⁷ Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK.
⁸ Harvard Medical School, Boston, Massachusetts, USA Institute for Healthcare Improvement, Cambridge, Massachusetts, USA.
⁹ Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK Harvard Medical School, Boston, Massachusetts, USA Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁰ Department of Surgery and Cancer, Imperial College London, London, UK.

PMID: 26628526
PMCID: PMC4680001
DOI: 10.1136/bmjopen-2015-009079

A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice

Andrew Carson-Stevens et al. BMJ Open. 2015.

. 2015 Dec 1;5(12):e009079.

doi: 10.1136/bmjopen-2015-009079.

Authors

Affiliations

¹ Primary Care Patient Safety (PISA) Research Group, Primary and Emergency Care Research (PRIME) Centre Wales, School of Medicine, Cardiff University, Wales, UK Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK.
² Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia Australian Patient Safety Foundation, Adelaide, Australia.
³ Division of General Practice, College of Community Health Sciences, University of Nottingham, Nottingham, UK.
⁴ Primary Care Patient Safety (PISA) Research Group, Primary and Emergency Care Research (PRIME) Centre Wales, School of Medicine, Cardiff University, Wales, UK.
⁵ Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA.
⁶ Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
⁷ Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK.
⁸ Harvard Medical School, Boston, Massachusetts, USA Institute for Healthcare Improvement, Cambridge, Massachusetts, USA.
⁹ Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK Harvard Medical School, Boston, Massachusetts, USA Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁰ Department of Surgery and Cancer, Imperial College London, London, UK.

PMID: 26628526
PMCID: PMC4680001
DOI: 10.1136/bmjopen-2015-009079

Abstract

Introduction: Incident reports contain descriptions of errors and harms that occurred during clinical care delivery. Few observational studies have characterised incidents from general practice, and none of these have been from the England and Wales National Reporting and Learning System. This study aims to describe incidents reported from a general practice care setting.

Methods and analysis: A general practice patient safety incident classification will be developed to characterise patient safety incidents. A weighted-random sample of 12,500 incidents describing no harm, low harm and moderate harm of patients, and all incidents describing severe harm and death of patients will be classified. Insights from exploratory descriptive statistics and thematic analysis will be combined to identify priority areas for future interventions.

Ethics and dissemination: The need for ethical approval was waivered by the Aneurin Bevan University Health Board research risk review committee given the anonymised nature of data (ABHB R&D Ref number: SA/410/13). The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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Figures

**Figure 1**
Example of codes from the Primary Care Patient Safety (PISA) Classification System using the Recursive Model for Incident Analysis.

**Figure 2**
Checklist of questions for coding orientation.

See this image and copyright information in PMC

References

1. Summary of inaugural meeting—the Safer Primary Care Expert Working Group. Geneva: World Health Organisation, 2012. http://www.who.int/patientsafety/summary_report_of_primary_care_consulta... (accessed 17 Nov 2015).
1. Cresswell KM, Panesar SS, Salvilla SA et al. . Global research priorities to better understand the burden of iatrogenic harm in primary care: an international Delphi exercise. PLoS Med 2013;10:e1001554 10.1371/journal.pmed.1001554 - DOI - PMC - PubMed
1. Sheikh A, Bates DW. Iatrogenic harm in primary care. Harvard Health Policy Review. Cambridge, MA: Harvard University, 2014:5–8.
1. Makeham MA, Stromer S, Bridges-Webb C et al. . Patient safety events reported in general practice: a taxonomy. Qual Saf Health Care 2008;17:53–7. 10.1136/qshc.2007.022491 - DOI - PubMed
1. Vincent C. Incident reporting and patient safety. BMJ 2007;334:51 10.1136/bmj.39071.441609.80 - DOI - PMC - PubMed

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A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice

Affiliations

A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical