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Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives

BACKGROUND: Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing com...

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Autores principales: Litchfield, Ian, Gill, Paramjit, Avery, Tony, Campbell, Stephen, Perryman, Katherine, Marsden, Kate, Greenfield, Sheila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964721/
https://www.ncbi.nlm.nih.gov/pubmed/29788906
http://dx.doi.org/10.1186/s12875-018-0761-2
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author Litchfield, Ian
Gill, Paramjit
Avery, Tony
Campbell, Stephen
Perryman, Katherine
Marsden, Kate
Greenfield, Sheila
author_facet Litchfield, Ian
Gill, Paramjit
Avery, Tony
Campbell, Stephen
Perryman, Katherine
Marsden, Kate
Greenfield, Sheila
author_sort Litchfield, Ian
collection PubMed
description BACKGROUND: Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing complexity of patients and their care. One such intervention is the multi-strand, single platform, Patient Safety Toolkit developed to help practices provide safer care in this dynamic and pressured environment where the likelihood of adverse incidents is increasing. Here we describe the attitudes of staff toward these tools and how their implementation was shaped by a number of contextual factors specific to each practice. METHODS: The Patient Safety Toolkit comprised six tools; a system of rapid note review, an online staff survey, a patient safety questionnaire, prescribing safety indicators, a medicines reconciliation tool, and a safe systems checklist. We implemented these tools at practices across the Midlands, the North West, and the South Coast of England and conducted semi-structured interviews to determine staff perspectives on their effectiveness and applicability. RESULTS: The Toolkit was used in 46 practices and a total of 39 follow-up interviews were conducted. Three key influences emerged on the implementation of the Toolkit these related to their ease of use and the novelty of the information they provide; whether their implementation required additional staff training or practice resource; and finally factors specific to the practice’s local environment such as overlapping initiatives orchestrated by their CCG. CONCLUSIONS: The concept of a balanced toolkit to address a range of safety issues proved popular. A number of barriers and facilitators emerged in particular those tools that provided relevant information with a minimum impact on practice resource were favoured. Individual practice circumstances also played a role. Practices with IT aware staff were at an advantage and those previously utilising patient safety initiatives were less likely to adopt additional tools with overlapping outputs. By acknowledging these influences we can better interpret reaction to and adoption of individual elements of the toolkit and optimise future implementation.
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spelling pubmed-59647212018-05-24 Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives Litchfield, Ian Gill, Paramjit Avery, Tony Campbell, Stephen Perryman, Katherine Marsden, Kate Greenfield, Sheila BMC Fam Pract Research Article BACKGROUND: Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing complexity of patients and their care. One such intervention is the multi-strand, single platform, Patient Safety Toolkit developed to help practices provide safer care in this dynamic and pressured environment where the likelihood of adverse incidents is increasing. Here we describe the attitudes of staff toward these tools and how their implementation was shaped by a number of contextual factors specific to each practice. METHODS: The Patient Safety Toolkit comprised six tools; a system of rapid note review, an online staff survey, a patient safety questionnaire, prescribing safety indicators, a medicines reconciliation tool, and a safe systems checklist. We implemented these tools at practices across the Midlands, the North West, and the South Coast of England and conducted semi-structured interviews to determine staff perspectives on their effectiveness and applicability. RESULTS: The Toolkit was used in 46 practices and a total of 39 follow-up interviews were conducted. Three key influences emerged on the implementation of the Toolkit these related to their ease of use and the novelty of the information they provide; whether their implementation required additional staff training or practice resource; and finally factors specific to the practice’s local environment such as overlapping initiatives orchestrated by their CCG. CONCLUSIONS: The concept of a balanced toolkit to address a range of safety issues proved popular. A number of barriers and facilitators emerged in particular those tools that provided relevant information with a minimum impact on practice resource were favoured. Individual practice circumstances also played a role. Practices with IT aware staff were at an advantage and those previously utilising patient safety initiatives were less likely to adopt additional tools with overlapping outputs. By acknowledging these influences we can better interpret reaction to and adoption of individual elements of the toolkit and optimise future implementation. BioMed Central 2018-05-22 /pmc/articles/PMC5964721/ /pubmed/29788906 http://dx.doi.org/10.1186/s12875-018-0761-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Litchfield, Ian
Gill, Paramjit
Avery, Tony
Campbell, Stephen
Perryman, Katherine
Marsden, Kate
Greenfield, Sheila
Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
title Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
title_full Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
title_fullStr Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
title_full_unstemmed Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
title_short Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
title_sort influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964721/
https://www.ncbi.nlm.nih.gov/pubmed/29788906
http://dx.doi.org/10.1186/s12875-018-0761-2
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