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Remediating doctors’ performance to restore patient safety: a realist review protocol

INTRODUCTION: Underperformance by doctors poses a risk to patient safety. Remediation is an intervention designed to remedy underperformance and return a doctor to safe practice. Remediation is widely used across healthcare systems globally, and has clear implications for both patient safety and doc...

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Autores principales: Price, Tristan, Brennan, Nicola, Cleland, Jennifer, Prescott-Clements, Linda, Wanner, Amanda, Withers, Lyndsey, Wong, Geoff, Archer, Julian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224734/
https://www.ncbi.nlm.nih.gov/pubmed/30373784
http://dx.doi.org/10.1136/bmjopen-2018-025943
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author Price, Tristan
Brennan, Nicola
Cleland, Jennifer
Prescott-Clements, Linda
Wanner, Amanda
Withers, Lyndsey
Wong, Geoff
Archer, Julian
author_facet Price, Tristan
Brennan, Nicola
Cleland, Jennifer
Prescott-Clements, Linda
Wanner, Amanda
Withers, Lyndsey
Wong, Geoff
Archer, Julian
author_sort Price, Tristan
collection PubMed
description INTRODUCTION: Underperformance by doctors poses a risk to patient safety. Remediation is an intervention designed to remedy underperformance and return a doctor to safe practice. Remediation is widely used across healthcare systems globally, and has clear implications for both patient safety and doctor retention. Yet, there is a poor evidence base to inform remediation programmes. In particular, there is a lack of understanding as to why and how a remedial intervention may work to change a doctor’s practice. The aim of this research is to identify why, how, in what contexts, for whom and to what extent remediation programmes for practising doctors work to support patient safety. METHODS AND ANALYSIS: Realist review is an approach to evidence synthesis that seeks to develop programme theories about how an intervention works to produce its effects. The initial search strategy will involve: database and grey literature searching, citation searching and contacting authors. The evidence search will be extended as the review progresses and becomes more focused on the development of specific aspects of the programme theory. The development of the programme theory will involve input from a stakeholder group consisting of professional experts in the remediation process and patient representatives. Evidence synthesis will use a realist logic of analysis to interrogate data in order to develop and refine the initial programme theory into a more definitive realist programme theory of how remediation works. The study will follow and be reported according to Realist And Meta-narrative Evidence Syntheses—Evolving Standards (RAMESES). ETHICS AND DISSEMINATION: Ethical approval is not required. Our dissemination strategy will include input from our stakeholder group. Customised outputs will be developed using the knowledge-to-action cycle framework, and will be targeted to: policy-makers; education providers and regulators, the National Health Service, doctors and academics. PROSPERO REGISTRATION NUMBER: CRD42018088779.
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spelling pubmed-62247342018-11-23 Remediating doctors’ performance to restore patient safety: a realist review protocol Price, Tristan Brennan, Nicola Cleland, Jennifer Prescott-Clements, Linda Wanner, Amanda Withers, Lyndsey Wong, Geoff Archer, Julian BMJ Open Medical Education and Training INTRODUCTION: Underperformance by doctors poses a risk to patient safety. Remediation is an intervention designed to remedy underperformance and return a doctor to safe practice. Remediation is widely used across healthcare systems globally, and has clear implications for both patient safety and doctor retention. Yet, there is a poor evidence base to inform remediation programmes. In particular, there is a lack of understanding as to why and how a remedial intervention may work to change a doctor’s practice. The aim of this research is to identify why, how, in what contexts, for whom and to what extent remediation programmes for practising doctors work to support patient safety. METHODS AND ANALYSIS: Realist review is an approach to evidence synthesis that seeks to develop programme theories about how an intervention works to produce its effects. The initial search strategy will involve: database and grey literature searching, citation searching and contacting authors. The evidence search will be extended as the review progresses and becomes more focused on the development of specific aspects of the programme theory. The development of the programme theory will involve input from a stakeholder group consisting of professional experts in the remediation process and patient representatives. Evidence synthesis will use a realist logic of analysis to interrogate data in order to develop and refine the initial programme theory into a more definitive realist programme theory of how remediation works. The study will follow and be reported according to Realist And Meta-narrative Evidence Syntheses—Evolving Standards (RAMESES). ETHICS AND DISSEMINATION: Ethical approval is not required. Our dissemination strategy will include input from our stakeholder group. Customised outputs will be developed using the knowledge-to-action cycle framework, and will be targeted to: policy-makers; education providers and regulators, the National Health Service, doctors and academics. PROSPERO REGISTRATION NUMBER: CRD42018088779. BMJ Publishing Group 2018-10-28 /pmc/articles/PMC6224734/ /pubmed/30373784 http://dx.doi.org/10.1136/bmjopen-2018-025943 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Medical Education and Training
Price, Tristan
Brennan, Nicola
Cleland, Jennifer
Prescott-Clements, Linda
Wanner, Amanda
Withers, Lyndsey
Wong, Geoff
Archer, Julian
Remediating doctors’ performance to restore patient safety: a realist review protocol
title Remediating doctors’ performance to restore patient safety: a realist review protocol
title_full Remediating doctors’ performance to restore patient safety: a realist review protocol
title_fullStr Remediating doctors’ performance to restore patient safety: a realist review protocol
title_full_unstemmed Remediating doctors’ performance to restore patient safety: a realist review protocol
title_short Remediating doctors’ performance to restore patient safety: a realist review protocol
title_sort remediating doctors’ performance to restore patient safety: a realist review protocol
topic Medical Education and Training
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224734/
https://www.ncbi.nlm.nih.gov/pubmed/30373784
http://dx.doi.org/10.1136/bmjopen-2018-025943
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