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Research article
Ian J Litchfield
University of Birmingham College of Medical and Dental Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1169-5392
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion.
Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.
Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful.
Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.
Keywords
Patient safety, checklist, general practice, quality indicators healthcare
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CURRENT STATUS: Published
Published
On 16 Jun, 2020
No community comments so far
Submission checks complete
On 03 Jun, 2020
Editorial decision: Accept
On 02 Jun, 2020
No comments provided
Editorial decision: Minor revision
On 24 May, 2020
Editor assigned
On 20 May, 2020
Submission checks complete
On 19 May, 2020
Editor invited
On 19 May, 2020
Version 2
Posted 30 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 15 May, 2020
Review #1 received
Received 12 May, 2020
Review #2 received
Received 05 May, 2020
Reviewer #2 agreed
On 28 Apr, 2020
Editor assigned
On 21 Apr, 2020
Reviewers invited
Invitations sent on 21 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Submission checks complete
On 20 Apr, 2020
Editor invited
On 20 Apr, 2020
No comments provided
Editorial decision: Major revision
On 05 Mar, 2020
Review #2 received
Received 23 Feb, 2020
Reviewer #2 agreed
On 02 Feb, 2020
Reviewer #3 agreed
On 02 Feb, 2020
Review #1 received
Received 08 Nov, 2019
Reviewer #1 agreed
On 30 Oct, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Submission checks complete
On 23 Sep, 2019
Editor assigned
On 21 Sep, 2019
Editor invited
On 20 Sep, 2019
First submitted
On 19 Sep, 2019
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Ian J Litchfield
University of Birmingham College of Medical and Dental Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1169-5392
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 16 Jun, 2020
No community comments so far
Submission checks complete
On 03 Jun, 2020
Editorial decision: Accept
On 02 Jun, 2020
No comments provided
Editorial decision: Minor revision
On 24 May, 2020
Editor assigned
On 20 May, 2020
Submission checks complete
On 19 May, 2020
Editor invited
On 19 May, 2020
Version 2
Posted 30 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 15 May, 2020
Review #1 received
Received 12 May, 2020
Review #2 received
Received 05 May, 2020
Reviewer #2 agreed
On 28 Apr, 2020
Editor assigned
On 21 Apr, 2020
Reviewers invited
Invitations sent on 21 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Submission checks complete
On 20 Apr, 2020
Editor invited
On 20 Apr, 2020
No comments provided
Editorial decision: Major revision
On 05 Mar, 2020
Review #2 received
Received 23 Feb, 2020
Reviewer #2 agreed
On 02 Feb, 2020
Reviewer #3 agreed
On 02 Feb, 2020
Review #1 received
Received 08 Nov, 2019
Reviewer #1 agreed
On 30 Oct, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Submission checks complete
On 23 Sep, 2019
Editor assigned
On 21 Sep, 2019
Editor invited
On 20 Sep, 2019
First submitted
On 19 Sep, 2019
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion.
Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.
Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful.
Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.
Figure 1
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