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Defining avoidable healthcare-associated harm in prisons: A mixed-method development study

BACKGROUND: Reducing avoidable healthcare-associated harm is a global health priority. Progress in evaluating the burden and aetiology of avoidable harm in prisons is limited compared with other healthcare sectors. To address this gap, this study aimed to develop a definition of avoidable harm to fa...

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Autores principales: Keers, Richard N., Wainwright, Verity, McFadzean, Joy, Davies, Kate, Campbell, Stephen M., Stevenson, Caroline, Purchase, Thomas, Shaw, Jennifer, Carson-Stevens, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10016636/
https://www.ncbi.nlm.nih.gov/pubmed/36920916
http://dx.doi.org/10.1371/journal.pone.0282021
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author Keers, Richard N.
Wainwright, Verity
McFadzean, Joy
Davies, Kate
Campbell, Stephen M.
Stevenson, Caroline
Purchase, Thomas
Shaw, Jennifer
Carson-Stevens, Andrew
author_facet Keers, Richard N.
Wainwright, Verity
McFadzean, Joy
Davies, Kate
Campbell, Stephen M.
Stevenson, Caroline
Purchase, Thomas
Shaw, Jennifer
Carson-Stevens, Andrew
author_sort Keers, Richard N.
collection PubMed
description BACKGROUND: Reducing avoidable healthcare-associated harm is a global health priority. Progress in evaluating the burden and aetiology of avoidable harm in prisons is limited compared with other healthcare sectors. To address this gap, this study aimed to develop a definition of avoidable harm to facilitate future epidemiological studies in prisons. METHODS: Using a sequential mixed methods study design we first characterised and reached consensus on the types and avoidability of patient harm in prison healthcare involving analysis of 151 serious prison incidents reported to the Strategic Executive Information System (StEIS) followed by in-depth nominal group (NG) discussions with four former service users and four prison professionals. Findings of the NG discussions and StEIS analysis were then synthesised and discussed among the research team and study oversight groups to develop an operational definition of avoidable harm in prison healthcare which was subsequently tested and validated using prison patient safety incident report data derived from the National Reporting and Learning System (NRLS). RESULTS: Analysis of StEIS incident reports and NG discussions identified important factors influencing avoidable harm which reflected the unique prison setting, including health care delivery issues and constraints associated with the secure environment which limited access to care. These findings informed the development of a new working two-tier definition of avoidable harm using appropriate and timely intervention, which included an additional assessment of harm avoidability taking into the account the prison regime and environment. The definition was compatible with the NRLS incident report narratives and illustrated how the prison environment may influence identification of avoidable harm and judgements of avoidability. CONCLUSIONS: We have developed a working definition of avoidable harm in prison health care that enables consideration of caveats associated with prison environments and systems. Our definition enables future studies of the safety of prison healthcare to standardise outcome measurement.
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spelling pubmed-100166362023-03-16 Defining avoidable healthcare-associated harm in prisons: A mixed-method development study Keers, Richard N. Wainwright, Verity McFadzean, Joy Davies, Kate Campbell, Stephen M. Stevenson, Caroline Purchase, Thomas Shaw, Jennifer Carson-Stevens, Andrew PLoS One Research Article BACKGROUND: Reducing avoidable healthcare-associated harm is a global health priority. Progress in evaluating the burden and aetiology of avoidable harm in prisons is limited compared with other healthcare sectors. To address this gap, this study aimed to develop a definition of avoidable harm to facilitate future epidemiological studies in prisons. METHODS: Using a sequential mixed methods study design we first characterised and reached consensus on the types and avoidability of patient harm in prison healthcare involving analysis of 151 serious prison incidents reported to the Strategic Executive Information System (StEIS) followed by in-depth nominal group (NG) discussions with four former service users and four prison professionals. Findings of the NG discussions and StEIS analysis were then synthesised and discussed among the research team and study oversight groups to develop an operational definition of avoidable harm in prison healthcare which was subsequently tested and validated using prison patient safety incident report data derived from the National Reporting and Learning System (NRLS). RESULTS: Analysis of StEIS incident reports and NG discussions identified important factors influencing avoidable harm which reflected the unique prison setting, including health care delivery issues and constraints associated with the secure environment which limited access to care. These findings informed the development of a new working two-tier definition of avoidable harm using appropriate and timely intervention, which included an additional assessment of harm avoidability taking into the account the prison regime and environment. The definition was compatible with the NRLS incident report narratives and illustrated how the prison environment may influence identification of avoidable harm and judgements of avoidability. CONCLUSIONS: We have developed a working definition of avoidable harm in prison health care that enables consideration of caveats associated with prison environments and systems. Our definition enables future studies of the safety of prison healthcare to standardise outcome measurement. Public Library of Science 2023-03-15 /pmc/articles/PMC10016636/ /pubmed/36920916 http://dx.doi.org/10.1371/journal.pone.0282021 Text en © 2023 Keers et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Keers, Richard N.
Wainwright, Verity
McFadzean, Joy
Davies, Kate
Campbell, Stephen M.
Stevenson, Caroline
Purchase, Thomas
Shaw, Jennifer
Carson-Stevens, Andrew
Defining avoidable healthcare-associated harm in prisons: A mixed-method development study
title Defining avoidable healthcare-associated harm in prisons: A mixed-method development study
title_full Defining avoidable healthcare-associated harm in prisons: A mixed-method development study
title_fullStr Defining avoidable healthcare-associated harm in prisons: A mixed-method development study
title_full_unstemmed Defining avoidable healthcare-associated harm in prisons: A mixed-method development study
title_short Defining avoidable healthcare-associated harm in prisons: A mixed-method development study
title_sort defining avoidable healthcare-associated harm in prisons: a mixed-method development study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10016636/
https://www.ncbi.nlm.nih.gov/pubmed/36920916
http://dx.doi.org/10.1371/journal.pone.0282021
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