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BMC Fam Pract. 2014 Jun 5;15:110. doi: 10.1186/1471-2296-15-110.

Tools for measuring patient safety in primary care settings using the RAND/UCLA appropriateness method.

Author information

1
Division of Primary Care, School of Community Health Sciences, University of Nottingham University Park, Medical School, Queen's Medical Centre, Nottingham NG7 2UH, England, UK. brian.bell@nottingham.ac.

Abstract

BACKGROUND:

The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcare setting and develop a 'toolkit' of feasible patient safety measures for general practices in England.

METHODS:

A RAND/UCLA Appropriateness Method exercise was conducted with a panel of international experts in general practice patient safety. Statements were developed from an extensive systematic literature review of patient safety in general practice. We used standard RAND/UCLA Appropriateness Method rating methods to identify necessary items for assessing patient safety in general practice, framed in terms of the Structure-Process-Outcome taxonomy. Items were included in the toolkit if they received an overall panel median score of ≥ 7 with agreement (no more than two panel members rating the statement outside a 3-point distribution around the median).

RESULTS:

Of 205 identified statements, the panel rated 101 as necessary for assessing the safety of general practices. Of these 101 statements, 73 covered structures or organisational issues, 22 addressed processes and 6 focused on outcomes.

CONCLUSIONS:

We developed and tested tools that can lead to interventions to improve safety outcomes in general practice. This paper reports the first attempt to systematically develop a patient safety toolkit for general practice, which has the potential to improve safety, cost effectiveness and patient experience, in any healthcare system.

PMID:
24902490
PMCID:
PMC4060097
DOI:
10.1186/1471-2296-15-110
[Indexed for MEDLINE]
Free PMC Article
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