Improving Patient Safety Culture in Primary Care: A Systematic Review
Patient safety has become a major topic in health-care research, and recently, its scope has been extended to primary care, as the role of primary care in health care increases in size and spending.1,2In The Netherlands, primary care covers a large part of healthcare: more than 90% of healthcare is delivered in primary care against only 4% of the total health-care costs.3 Although incidents in primary care tend to be less harmful compared with incidents that occur in hospitals, the impact on overall safety in health care is at least similar because of the large number of patient contacts in primary care.2,4
In primary care, patient safety research initially focused on studying taxonomy5 and reporting systems.6,7 These studies found that the majority of incidents can be categorized as process incidents including administrative failures. Other important categories were communication, knowledge, and skills. Gaal et al.8 found patient safety incidents in 2.5% of patient contacts by reviewing general practice medical records, and communication was one of the reported causes. Another study in 48 primary care centers in Spain, identified 773 adverse events and stated that problems with communication and management were at the root of many of these events.9 Reviewing 75 error reports, Woolf et al. found that 77% of the incidents were caused by a cascade of errors.10 This shows that collaboration and communication are relevant issues to patient safety in primary care.
The way colleagues interact and collaborate in an organization is part of their culture. Safety culture is described as the shared values, attitudes, and behavior of all staff in health facilities in regard to giving safety priority over efficiency, improving care provider communication and collaboration, and creating a system that learns about and learns from errors and problems.11 Furthermore, it is known that a safe and open culture is important for patient safety improvement.12
Para acceder al sitio, haga Clic Aquí