Monitoring patient safety in primary care: an exploratory study using in-depth semistructured interviews

OBJECTIVES: To explore how information and data are used to monitor patient safety and quality of primary care by professionals working in, or supporting, primary healthcare. DESIGN: Qualitative study of semistructured interviews with a directed content analysis of transcripts. SETTING: North-West London, UK. PARTICIPANTS: 21 individuals from various levels of the primary healthcare system were recruited, including general practitioners, practice nurses, practice managers, members of Clinical Commissioning Group (CCG) governing bodies, and senior members of regional patient safety teams. RESULTS: Participants described being overwhelmed with complicated data which lacked any meaningful analyses about safety and quality. There was also a lack of clarity over which patient safety events are expected to be reported or monitored. Participants also reported uncertainty on whose responsibility it was to act on patient safety information or concerns. At the practice level, there was a range of disincentives for responding to and acting on safety issues and concerns, with few reported benefits. Participants made recommendations to improve future monitoring. CONCLUSIONS: There is a need for clearer information in the form of specific guidelines, policies and procedures with regard to who monitors patient safety in primary care, what is monitored and how it should be monitored.