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Patient safety work in Sweden: quantitative and qualitative analysis of annual patient safety reports.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Primary Health Care in Central County.ORCID iD: 0000-0001-9116-8156
2016 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, no 98, 1-9 p.Article in journal (Refereed) Published
Abstract [en]

Background

There is widespread recognition of the problem of unsafe care and extensive efforts have been made over the last 15 years to improve patient safety. In Sweden, a new patient safety law obliges the 21 county councils to assemble a yearly patient safety report (PSR). The aim of this study was to describe the patient safety work carried out in Sweden by analysing the PSRs with regard to the structure, process and result elements reported, and to investigate the perceived usefulness of the PSRs as a tool to achieve improved patient safety.

Methods

The study was based on two sources of data: patient safety reports obtained from county councils in Sweden published in 2014 and a survey of health care practitioners with strategic positions in patient safety work, acting as key informants for their county councils. Answers to open-ended questions were analysed using conventional content analysis.

Results

A total of 14 structure elements, 31 process elements and 23 outcome elements were identified. The most frequently reported structure elements were groups devoted to working with antibiotics issues and electronic incident reporting systems. The PSRs were perceived to provide a structure for patient safety work, enhance the focus on patient safety and contribute to learning about patient safety.

Conclusion

Patient safety work carried out in Sweden, as described in annual PSRs, features a wide range of structure, process and result elements. According to health care practitioners with strategic positions in the county councils’ patient safety work, the PSRs are perceived as useful at various system levels.

Place, publisher, year, edition, pages
BioMed Central, 2016. Vol. 16, no 98, 1-9 p.
Keyword [en]
Healthcare, Patient safety, Patient safety reports
National Category
Social and Clinical Pharmacy Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-127298DOI: 10.1186/s12913-016-1350-5ISI: 000372864800001PubMedID: 27001079OAI: oai:DiVA.org:liu-127298DiVA: diva2:921157
Note

Funding agencies:  Swedish National Board of Health and Welfare

Available from: 2016-04-19 Created: 2016-04-19 Last updated: 2017-11-30Bibliographically approved
In thesis
1. Towards safer care in Sweden?: Studies of influences on patient safety
Open this publication in new window or tab >>Towards safer care in Sweden?: Studies of influences on patient safety
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Patient safety has progressed in 15 years from being a relatively insignificant issue to a position high on the agenda for health care providers, managers and policymakers as well as the general public. Sweden has seen increased national, regional and local patient safety efforts since 2011 when a new patient safety law was introduced and a four-year financial incentive plan was launched to encourage county councils to carry out specified measures and meet certain patient safety related criteria. However, little is known about what structures and processes contribute to improved patient safety outcomes and how the context influences the results.

The overall aim of this thesis was to generate knowledge for improved understanding and explanation of influences on patient safety in the county councils in Sweden. To address this issue, five studies were con-ducted: interviews with nurses and infection control practitioners, surveys to patient safety officers and a document analysis of patient safety reports. Patient safety officers are healthcare professionals who hold key positions in their county council’s patient safety work. The findings from the studies were structured through a framework based on Donabedian’s triad (with a contextual element added) and applying a learning perspective, highlight areas that are potentially important to improve the patient safety in Swe-dish county councils.

Study I showed that the conditions for the county councils’ patient safety work could be improved. Conducting root-cause analysis and attaining an organizational culture that encourages reporting and avoids blame were perceived to be of importance for improving patient safety. Study II showed that nurses perceived facilitators and barriers for improved pa-tient safety at several system levels. Study III revealed many different types of obstacles to effective surveillance of health care-associated infec-tions (HAIs), the majority belonging to the early stages of the surveillance process. Many of the obstacles described by the infection control practi-tioners restricted the use of results in efforts to reduce HAIs. Study IV of the Patient Safety Reports identified 14 different structure elements of patient safety work, 31 process elements and 23 outcome elements. These reports were perceived by patient safety officers to be useful for providing a structure for patient safety work in the county councils, for enhancing the focus on patient safety issues and for learning from the patient safety work that is undertaken. In Study V the patient safety officers rated efforts to reduce the use of antibiotics and improved communication be-tween health care practitioners and patients as most important for attaining current and future levels of patient safety in their county council. The patient safety officers also perceived that the most successful county councils regarding patient safety have good leadership support, a long-term commitment and a functional work organisation for patient safety work.

Taken together, the five studies of this thesis demonstrate that patient safety is a multifaceted problem that requires multifaceted solutions. The findings point to an insufficient transition of assembled data and information into action and learning for improved patient safety.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 96 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1503
Keyword
Patient safety, interventions, perceptions, learning from errors, patient safety reports, learning organization, patientsäkerhet, patientsäkerhetsberättelse, nationella initiativ, lärande organisation, uppfattningar
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-127307 (URN)10.3384/diss.diva-127307 (DOI)978-91-7685-857-8 (ISBN)
Public defence
2016-04-22, Belladonna, Hus 511-001, Campus US, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2016-04-27 Created: 2016-04-19 Last updated: 2016-04-27Bibliographically approved

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Ridelberg, MikaelaRoback, KerstinNilsen, PerCarlfjord, Siw

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