Strength of Safety Measures Introduced by Medical Practices to Prevent a Recurrence of Patient Safety Incidents: An Observational Study : Journal of Patient Safety

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Original Articles

Strength of Safety Measures Introduced by Medical Practices to Prevent a Recurrence of Patient Safety Incidents: An Observational Study

Müller, Beate S. MD; Lüttel, Dagmar MSc; Schütze, Dania MA; Blazejewski, Tatjana; Pommée, Marina MA; Müller, Hardy MA; Rubin, Katharina; Thomeczek, Christian MD§; Schadewitz, Romy§; Kintrup, Andreas; Heuzeroth, Reiner; Beyer, Martin; Schwappach, David MPH∗∗,††; Hecker, Ruth MD; Gerlach, Ferdinand M. MD, MPH

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Journal of Patient Safety 18(5):p 444-448, August 2022. | DOI: 10.1097/PTS.0000000000000953

Abstract

Objective 

The aim of this study was to analyze the strength of safety measures described in incident reports in outpatient care.

Methods 

An incident reporting project in German outpatient care included 184 medical practices with differing fields of specialization. The practices were invited to submit anonymous incident reports to the project team 3 times for 17 months. Using a 14-item coding scheme based on international recommendations, we deductively coded the incident reports and safety measures. Safety measures were classified as “strong” (likely to be effective and sustainable), “intermediate” (possibly effective and sustainable), or “weak” (less likely to be effective and sustainable).

Results 

The practices submitted 245 incident reports. In 160 of them, 243 preventive measures were described, or an average of 1.5 per report. The number of documented measures varied from 1 in 67% to 4 in 5% of them. Four preventive measures (2%) were classified as strong, 37 (15%) as intermediate, and 202 (83%) as weak. The most frequently mentioned measures were “new procedure/policy” (n = 121) and “information/notification/warning” (n = 45).

Conclusions 

The study provides examples of critical incidents in medical practices and for the first time examines the strength of ensuing measures introduced in outpatient care. Overall, the proportion of weak measures is (too) high, indicating that practices need more support in identifying strong measures.

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