Patient involvement in measuring and monitoring patient safety in general practice
Madden, Caoimhe
Madden, Caoimhe
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Publication Date
2022-07-01
Type
Thesis
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Citation
Abstract
Given their unique viewpoint at the epicentre of the care process, patients can make a unique contribution to improving our understanding of safety in general practice. Despite this, patients remain an underutilised resource in the measurement and monitoring of safety. Therefore, this thesis aimed to: (1) identify an approach to how patients can contribute to the measurement and monitoring of safety climate; and (2) ascertain the value of patient data for identifying and learning from past harm in general practice. These were addressed through the conduct of a systematic review and three empirical studies. Study One comprised a systematic review of existing patient-report safety climate measures in healthcare and provided an assessment of their psychometric properties and coverage of safety climate domains. Issues were identified with validity, reliability, usability and a lack of agreement on the appropriate safety climate domains. Study Two described the development and evaluation of a novel, patientreport measure of safety climate for general practice. Five distinctive factors pertaining to safety climate were identified, and the measure was found to be both valid and reliable. Study Three examined the application of this novel measure, to evaluate the patient perceptions of safety climate in Irish general practice and explore whether these perceptions differ according to patient characteristics. It was found that respondents generally reported positive perceptions of safety- although over twothirds of free-text responses related to ‘poor’ SC practices. Study Four examined the value of utilising a qualitative approach to assess past harm via ‘patient stories’, resulting in rich descriptions about safety deficiencies in general practice. Findings confirmed that patients provide additional and unique information about safety outcomes often unrecognised by healthcare professionals. This thesis has established that patients are a valuable source of information about safety in general practice, thus a concerted effort to effectively utilise this evidence in the emerging field of patient involvement in healthcare is recommended.
Publisher
NUI Galway