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An approach to assessing patient safety in hospitals in low-income countries.

Lindfield R, Knight A, Bwonya D - PLoS ONE (2015)

Bottom Line: Overall both hospitals demonstrated good patient safety practices however areas for improvement were staff-patient communication, the presence and use of protocols and a focus on consistent practice.The methods allowed the complexity of patient safety to be understood and explained with areas of concern highlighted.The next step will be to develop a useful and easy to use tool to measure patient safety practices in low-income settings.

View Article: PubMed Central - PubMed

Affiliation: Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.

ABSTRACT

Objective: The aim of the study was to assess non-technical aspects of patient safety practices using non-participant observation in different clinical areas.

Design: Qualitative study using non-participant observation and thematic analysis.

Setting: Two eye care units in Uganda.

Participants: Staff members in each hospital.

Main outcome measures: A set of observations of patient safety practices by staff members in clinical areas that were then coded using thematic analysis.

Results: Twenty codes were developed that explained patient safety practices in the hospitals based on the observations. These were grouped into four themes: the team, the environment, patient-centred care and the process. The complexity of patient safety in each hospital was described using narrative reports to support the thematic analysis. Overall both hospitals demonstrated good patient safety practices however areas for improvement were staff-patient communication, the presence and use of protocols and a focus on consistent practice.

Conclusions: This is the first holistic assessment of patient safety practices in a low-income setting. The methods allowed the complexity of patient safety to be understood and explained with areas of concern highlighted. The next step will be to develop a useful and easy to use tool to measure patient safety practices in low-income settings.

No MeSH data available.


Narrative from operating theatre observation, Hospital B.
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pone.0121628.g003: Narrative from operating theatre observation, Hospital B.

Mentions: The complexity of patient safety practices across different clinical areas in the same hospital, with evidence of good and poor practices, sometimes by the same member of staff, meant that coding alone led to loss of important nuances. Coding also meant that important patient safety issues were given the same weight as potentially less important issues. To deal with these nuances, capture the differences and attempt to draw attention to the most important issues, a narrative was produced describing the evidence from each clinical area. Fig 2 shows part of the narrative from the operating theatre observations in one hospital, showing the importance of evidence of absence of procedures or practices. Fig 3 is part of the narrative from the second hospital illustrating themes relating to capacity, collaboration and roles.


An approach to assessing patient safety in hospitals in low-income countries.

Lindfield R, Knight A, Bwonya D - PLoS ONE (2015)

Narrative from operating theatre observation, Hospital B.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4403808&req=5

pone.0121628.g003: Narrative from operating theatre observation, Hospital B.
Mentions: The complexity of patient safety practices across different clinical areas in the same hospital, with evidence of good and poor practices, sometimes by the same member of staff, meant that coding alone led to loss of important nuances. Coding also meant that important patient safety issues were given the same weight as potentially less important issues. To deal with these nuances, capture the differences and attempt to draw attention to the most important issues, a narrative was produced describing the evidence from each clinical area. Fig 2 shows part of the narrative from the operating theatre observations in one hospital, showing the importance of evidence of absence of procedures or practices. Fig 3 is part of the narrative from the second hospital illustrating themes relating to capacity, collaboration and roles.

Bottom Line: Overall both hospitals demonstrated good patient safety practices however areas for improvement were staff-patient communication, the presence and use of protocols and a focus on consistent practice.The methods allowed the complexity of patient safety to be understood and explained with areas of concern highlighted.The next step will be to develop a useful and easy to use tool to measure patient safety practices in low-income settings.

View Article: PubMed Central - PubMed

Affiliation: Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.

ABSTRACT

Objective: The aim of the study was to assess non-technical aspects of patient safety practices using non-participant observation in different clinical areas.

Design: Qualitative study using non-participant observation and thematic analysis.

Setting: Two eye care units in Uganda.

Participants: Staff members in each hospital.

Main outcome measures: A set of observations of patient safety practices by staff members in clinical areas that were then coded using thematic analysis.

Results: Twenty codes were developed that explained patient safety practices in the hospitals based on the observations. These were grouped into four themes: the team, the environment, patient-centred care and the process. The complexity of patient safety in each hospital was described using narrative reports to support the thematic analysis. Overall both hospitals demonstrated good patient safety practices however areas for improvement were staff-patient communication, the presence and use of protocols and a focus on consistent practice.

Conclusions: This is the first holistic assessment of patient safety practices in a low-income setting. The methods allowed the complexity of patient safety to be understood and explained with areas of concern highlighted. The next step will be to develop a useful and easy to use tool to measure patient safety practices in low-income settings.

No MeSH data available.