Developing a Framework for Assessing the Safety of the Recipients of Primary Health Care Services
-
Abbasali Dorosti
,
Mostafa Farahbakhsh
,
Mahdi Nouri
,
Majid Karamoz
,
Hojat gharaee
,
Hossien Khosroshi
,
Salar Mohammaddokht
,
Saber Azami-Aghdash
Abstract
Background: Safety has been neglected in primary health care (PHC). A review of the literature shows that a comprehensive and specific framework to assess the safety of service recipients (SRs) in PHC has not yet been developed.
Objectives:Therefore, this study aimed to design and validate a framework for assessing the safety of SRs in PHC.
Methods: This study was a qualitative research based on a grounded theory approach, designed and conducted by the Vice-Chancellor for Health of Tabriz University of Medical Sciences in 2020. The present study was conducted at three stages: conducting a comprehensive literature review, consulting 15 experts and officials of the country and the province, and conducting two stages of the Delphi technique with the participation of 23 experts. Content analysis was used to analyze the data.
Results: In the literature review phase, 114 criteria were identified from 16 references. Finally, 71 criteria (six main areas and 20 subareas) were identified for assessing the safety of SRs in PHC. The main areas included management and leadership (26 criteria), process management (eight criteria), SRs’ safety audit (15 criteria), human resources (five criteria), SRs and community participation (five criteria), and occupational safety (12 criteria).
Conclusions: In this study, a comprehensive and systematic framework was designed, and criteria for measuring the safety of SRs in PHC were validated, which can be used by policymakers and officials of PHC.
1. World Health Organization. Definition of Terms. Retrieved 26 August 2014.
2. The world health report 2008: primary health care now more than ever: introduction and overview. 2008.
3. Booth M, Hill G, Moore MJ, Dalla D, Moore M, Messenger A. The new Australian Primary Health Networks: how will they integrate public health and primary care. Public Health Res Pract. 2016;26(1):e2611603.
4. Webair HH, Al-Assani SS, Al-Haddad RH, Al-Shaeeb WH, Selm MAB, Alyamani AS. Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen. BMC family practice. 2015;16(1):136.
5. Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Cmaj. 2004;170(11):1678-86.
6. Davis P, Lay-Yee R, Briant R, Scott A. Preventable in-hospital medical injury under the “no fault” system in New Zealand. BMJ Quality & Safety. 2003;12(4):251-6.
7. Woods DM, Thomas EJ, Holl JL, Weiss KB, Brennan TA. Ambulatory care adverse events and preventable adverse events leading to a hospital admission. BMJ Quality & Safety. 2007;16(2):127-31.
8. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system: National academy press Washington, DC; 2000.
9. Green LA, Fryer Jr GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. Mass Medical Soc; 2001.
10. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC health services research. 2010;10(1):199.
11. Bhasale AL, Miller GC, Reid SE, Britt HC. Analysing potential harm in Australian general practice: an incident‐monitoring study. Medical journal of Australia. 1998;169(2):73-6.
12. Britt H, Miller G, Steven I, Howarth G, Nicholson P, Bhasale A, et al. Collecting data on potentially harmful events: a method for monitoring incidents in general practice. Family practice. 1997;14(2):101-6.
13. Elder NC, Meulen MV, Cassedy A. The identification of medical errors by family physicians during outpatient visits. The Annals of Family Medicine. 2004;2(2):125-9.
14. Hing E, Middleton K. National hospital ambulatory medical care survey: 2001 outpatient department summary. Advance data from vital and health statistics. 2001(338).
15. Panesar SS, Desilva D, Carson-Stevens A, Cresswell KM, Salvilla SA, Slight SP, et al. How safe is primary care? A systematic review. BMJ quality & safety. 2016;25(7):544-53.
16. Spencer R, Campbell SM. Tools for primary care patient safety: a narrative review. BMC family practice. 2014;15(1):166.
17. Solberg LI, Mosser G, McDonald S. The three faces of performance measurement: improvement, accountability, and research. Joint Commission Journal on Quality and Patient Safety. 1997;23(3):135-47.
18. Lorincz C, Drazen E, Sokol P, Neerukonda K, Metzger J, Toepp M, et al. Research in ambulatory patient safety 2000–2010: a 10-year review. Chicago IL: American Medical Association. 2011;106.
19. Grbich C. Qualitative data analysis: An introduction: Thousand Oaks. CA: Sage; 2007.
20. ope C, Ziebland S, Mays N. Analysing qualitative data British Medical Journal. 2000;320:114-6.
21. Azami-Aghdash S, Tabrizi JS, Sadeghi-Bazargani H, Hajebrahimi S, Naghavi-Behzad M. Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness. Int J Qual Health Care. 2015;27(2):110-6.
22. Hatoun J, Chan JA, Yaksic E, Greenan MA, Borzecki AM, Shwartz M, et al. A systematic review of patient safety measures in adult primary care. American Journal of Medical Quality. 2017;32(3):237-45.
23. Heath I, Rubinstein A, Stange KC, Van Driel ML. Quality in primary health care: a multidimensional approach to complexity. Bmj. 2009;338:b1242.
24. McMurray A. Leadership in primary health care: an international perspective. Contemporary nurse. 2007;26(1):30-6.
25. Flahault D, Roemer MI, World Health O. Leadership for primary health care : levels, functions, and requirements based on twelve case studies / Daniel Flahault, Milton I. Roemer. Geneva: World Health Organization; 1986.
26. Cleary S, Toit Ad, Scott V, Gilson L. Enabling relational leadership in primary healthcare settings: lessons from the DIALHS collaboration. Health Policy and Planning. 2018;33(suppl_2):ii65-ii74.
27. Bath J, Wakerman J. Impact of community participation in primary health care: what is the evidence? Australian Journal of Primary Health. 2015;21(1):2-8.
28. McEvoy R, MacFarlane A. Community participation in primary care in Ireland: the need for implementation research. Primary Health Care Research & Development. 2013;14(2):126-39.
29. Preston R, Waugh H, Taylor J, Larkins S, editors. The benefits of community participation in rural health service development: where is the evidence?2009: National Rural Health Conference Proceedings.
30. Nimegeer A. Considering community engagement for remote and rural healthcare design in Scotland: exploring the journey from rhetoric to reality: University of Aberdeen; 2013.
31. McEvoy R, Tierney E, MacFarlane A. ‘Participation is integral’: understanding the levers and barriers to the implementation of community participation in primary healthcare: a qualitative study using normalisation process theory. BMC Health Services Research. 2019;19(1):515.
32. Organization WH. Primary health care: A joint report: World Health Organization; 1978.
33. King A, Daniels J, Lim J, Cochrane D, Taylor A, Ansermino J. Time to listen: a review of methods to solicit patient reports of adverse events. BMJ Quality & Safety. 2010;19(2):148-57.
34. Saadati M, Nouri M, Rezapour R. Patient safety walkrounds; 5 years of experience in a developing country. The International journal of health planning and management. 2019;34(2):773-9.
35. Bittle MJ, LaMarche S. Engaging the patient as observer to promote hand hygiene compliance in ambulatory care. The Joint Commission Journal on Quality and Patient Safety. 2009;35(10):519-AP3.
36. Schwappach DL. Engaging patients as vigilant partners in safety: a systematic review. Medical Care Research and Review. 2010;67(2):119-48.
37. Barzegar MA, Djazayery A. Evaluation of rural primary health care services in Iran: report on vital statistics in West Azarbaijan. Am J Public Health. 1981;71(7):739-42.
38. Shadpour K. Primary health care networks in the Islamic Republic of Iran. East Mediterr Health J. 2000;6(4):822-5.
39. Mehrdad R. Health system in Iran. JMAJ. 2009;52(1):69-73.
40. Tavassoli M. Iranian health houses open the door to primary care. Bulletin of the World Health Organization. 2008;86(8):585-6.
41. Baygi MZ, Seyedin H, Salehi M, Sirizi MJ. Structural and contextual dimensions of Iranian primary health care system at local level. Iranian Red Crescent Medical Journal. 2015;17(1).
42. Naeli J, Moghimi D. Document policies to improve primary Health care. 2006.
43. Organization WH. 60th Assembly. Resolution WHA60. 26-Workers’ health: global plan of action. Resolution WHA6026 Geneva: WHO. 2007;8.
44. World Health Organization. Connecting health and labour. What role for occupational health in primary health care? Geneva: WHO; 2011. http://www.who.int/occupational_health/publications/hague_executive_summary/en/index.html.
45. Buijs P, Gunnyeon B, van Weel C. Primary health care: what role for occupational health? Br J Gen Pract. 2012;62(605):623-4.
46. Orbon K, Buijs P, Folgering H, Thoonen B, Schermer T. Occupational health and general practice: from opportunities lost to opportunities capitalised? La Medicina del lavoro. 2006;97(2):288-94.
47. Ozturk H, Babacan E. The occupational safety of health professionals working at community and family health centers. Iranian Red Crescent medical journal. 2014;16(10):e16319-e.
2. The world health report 2008: primary health care now more than ever: introduction and overview. 2008.
3. Booth M, Hill G, Moore MJ, Dalla D, Moore M, Messenger A. The new Australian Primary Health Networks: how will they integrate public health and primary care. Public Health Res Pract. 2016;26(1):e2611603.
4. Webair HH, Al-Assani SS, Al-Haddad RH, Al-Shaeeb WH, Selm MAB, Alyamani AS. Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen. BMC family practice. 2015;16(1):136.
5. Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Cmaj. 2004;170(11):1678-86.
6. Davis P, Lay-Yee R, Briant R, Scott A. Preventable in-hospital medical injury under the “no fault” system in New Zealand. BMJ Quality & Safety. 2003;12(4):251-6.
7. Woods DM, Thomas EJ, Holl JL, Weiss KB, Brennan TA. Ambulatory care adverse events and preventable adverse events leading to a hospital admission. BMJ Quality & Safety. 2007;16(2):127-31.
8. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system: National academy press Washington, DC; 2000.
9. Green LA, Fryer Jr GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. Mass Medical Soc; 2001.
10. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC health services research. 2010;10(1):199.
11. Bhasale AL, Miller GC, Reid SE, Britt HC. Analysing potential harm in Australian general practice: an incident‐monitoring study. Medical journal of Australia. 1998;169(2):73-6.
12. Britt H, Miller G, Steven I, Howarth G, Nicholson P, Bhasale A, et al. Collecting data on potentially harmful events: a method for monitoring incidents in general practice. Family practice. 1997;14(2):101-6.
13. Elder NC, Meulen MV, Cassedy A. The identification of medical errors by family physicians during outpatient visits. The Annals of Family Medicine. 2004;2(2):125-9.
14. Hing E, Middleton K. National hospital ambulatory medical care survey: 2001 outpatient department summary. Advance data from vital and health statistics. 2001(338).
15. Panesar SS, Desilva D, Carson-Stevens A, Cresswell KM, Salvilla SA, Slight SP, et al. How safe is primary care? A systematic review. BMJ quality & safety. 2016;25(7):544-53.
16. Spencer R, Campbell SM. Tools for primary care patient safety: a narrative review. BMC family practice. 2014;15(1):166.
17. Solberg LI, Mosser G, McDonald S. The three faces of performance measurement: improvement, accountability, and research. Joint Commission Journal on Quality and Patient Safety. 1997;23(3):135-47.
18. Lorincz C, Drazen E, Sokol P, Neerukonda K, Metzger J, Toepp M, et al. Research in ambulatory patient safety 2000–2010: a 10-year review. Chicago IL: American Medical Association. 2011;106.
19. Grbich C. Qualitative data analysis: An introduction: Thousand Oaks. CA: Sage; 2007.
20. ope C, Ziebland S, Mays N. Analysing qualitative data British Medical Journal. 2000;320:114-6.
21. Azami-Aghdash S, Tabrizi JS, Sadeghi-Bazargani H, Hajebrahimi S, Naghavi-Behzad M. Developing performance indicators for clinical governance in dimensions of risk management and clinical effectiveness. Int J Qual Health Care. 2015;27(2):110-6.
22. Hatoun J, Chan JA, Yaksic E, Greenan MA, Borzecki AM, Shwartz M, et al. A systematic review of patient safety measures in adult primary care. American Journal of Medical Quality. 2017;32(3):237-45.
23. Heath I, Rubinstein A, Stange KC, Van Driel ML. Quality in primary health care: a multidimensional approach to complexity. Bmj. 2009;338:b1242.
24. McMurray A. Leadership in primary health care: an international perspective. Contemporary nurse. 2007;26(1):30-6.
25. Flahault D, Roemer MI, World Health O. Leadership for primary health care : levels, functions, and requirements based on twelve case studies / Daniel Flahault, Milton I. Roemer. Geneva: World Health Organization; 1986.
26. Cleary S, Toit Ad, Scott V, Gilson L. Enabling relational leadership in primary healthcare settings: lessons from the DIALHS collaboration. Health Policy and Planning. 2018;33(suppl_2):ii65-ii74.
27. Bath J, Wakerman J. Impact of community participation in primary health care: what is the evidence? Australian Journal of Primary Health. 2015;21(1):2-8.
28. McEvoy R, MacFarlane A. Community participation in primary care in Ireland: the need for implementation research. Primary Health Care Research & Development. 2013;14(2):126-39.
29. Preston R, Waugh H, Taylor J, Larkins S, editors. The benefits of community participation in rural health service development: where is the evidence?2009: National Rural Health Conference Proceedings.
30. Nimegeer A. Considering community engagement for remote and rural healthcare design in Scotland: exploring the journey from rhetoric to reality: University of Aberdeen; 2013.
31. McEvoy R, Tierney E, MacFarlane A. ‘Participation is integral’: understanding the levers and barriers to the implementation of community participation in primary healthcare: a qualitative study using normalisation process theory. BMC Health Services Research. 2019;19(1):515.
32. Organization WH. Primary health care: A joint report: World Health Organization; 1978.
33. King A, Daniels J, Lim J, Cochrane D, Taylor A, Ansermino J. Time to listen: a review of methods to solicit patient reports of adverse events. BMJ Quality & Safety. 2010;19(2):148-57.
34. Saadati M, Nouri M, Rezapour R. Patient safety walkrounds; 5 years of experience in a developing country. The International journal of health planning and management. 2019;34(2):773-9.
35. Bittle MJ, LaMarche S. Engaging the patient as observer to promote hand hygiene compliance in ambulatory care. The Joint Commission Journal on Quality and Patient Safety. 2009;35(10):519-AP3.
36. Schwappach DL. Engaging patients as vigilant partners in safety: a systematic review. Medical Care Research and Review. 2010;67(2):119-48.
37. Barzegar MA, Djazayery A. Evaluation of rural primary health care services in Iran: report on vital statistics in West Azarbaijan. Am J Public Health. 1981;71(7):739-42.
38. Shadpour K. Primary health care networks in the Islamic Republic of Iran. East Mediterr Health J. 2000;6(4):822-5.
39. Mehrdad R. Health system in Iran. JMAJ. 2009;52(1):69-73.
40. Tavassoli M. Iranian health houses open the door to primary care. Bulletin of the World Health Organization. 2008;86(8):585-6.
41. Baygi MZ, Seyedin H, Salehi M, Sirizi MJ. Structural and contextual dimensions of Iranian primary health care system at local level. Iranian Red Crescent Medical Journal. 2015;17(1).
42. Naeli J, Moghimi D. Document policies to improve primary Health care. 2006.
43. Organization WH. 60th Assembly. Resolution WHA60. 26-Workers’ health: global plan of action. Resolution WHA6026 Geneva: WHO. 2007;8.
44. World Health Organization. Connecting health and labour. What role for occupational health in primary health care? Geneva: WHO; 2011. http://www.who.int/occupational_health/publications/hague_executive_summary/en/index.html.
45. Buijs P, Gunnyeon B, van Weel C. Primary health care: what role for occupational health? Br J Gen Pract. 2012;62(605):623-4.
46. Orbon K, Buijs P, Folgering H, Thoonen B, Schermer T. Occupational health and general practice: from opportunities lost to opportunities capitalised? La Medicina del lavoro. 2006;97(2):288-94.
47. Ozturk H, Babacan E. The occupational safety of health professionals working at community and family health centers. Iranian Red Crescent medical journal. 2014;16(10):e16319-e.
| Files | ||
| Issue | Vol 4, No 3 (2020) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v4i3.6349 | |
| Keywords | ||
| Primary Health Care Safety Service Recipient Framework Criteria | ||
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How to Cite
1.
Dorosti A, Farahbakhsh M, Nouri M, Karamoz M, gharaee H, Khosroshi H, Mohammaddokht S, Azami-Aghdash S. Developing a Framework for Assessing the Safety of the Recipients of Primary Health Care Services. Health Tech Ass Act. 2021;4(3).
