title: Significant event analysis: a comparative study of knowledge, process and attitudes in primary care.
abstract: BACKGROUND
  Significant event analysis (SEA) is now well established in UK primary care. Previously, considerable variation has been reported in the knowledge, skills and attitudes of general practitioners undertaking SEA. Little is known about the wider team's understanding, participation or perceptions. We therefore aimed to determine the awareness, degree of analysis and perceived risk of recurrence of a recent significant event, types of discussion forums, staff groups' participation and perceived barriers. Comparisons were made with a 2003 survey and significant changes described.
  
  
  METHODS
  A postal questionnaire survey was undertaken of a random selection of general practice team members in National Health Service Greater Glasgow in 2008/9.
  
  
  RESULTS
  In total, 375/711 respondents (53%) from 111 practices participated. The vast majority was aware of a recent significant event, 29% reported not implementing a change and 23% perceived the risk of recurrence as moderate to high. Administrative and community-based staff were infrequently involved in meetings. Dedicated significant event meetings remain uncommon (P = 0.06). Perceptions improved since 2003, but lack of time remained a concern.
  
  
  CONCLUSIONS
  This survey was the first known attempt to include all members of the primary care team while studying SEA. Awareness and analysis levels were high, but only lead to sustainable improvement of care quality and clinical safety if teams implement change. Greater use should be made of dedicated SEA meetings and participation of all staff groups increased to gain full benefits. Lack of time can be managed pragmatically by prioritizing events based on their perceived severity, potential for change and potential team involvement.
authors.affiliation: NHS Education for Scotland, Glasgow, UK. carl.dewet@nes.scot.nhs.uk
authors.forename: Carl
authors.initials: C
authors.lastname: de Wet
authors.forename: Nick
authors.initials: N
authors.lastname: Bradley
authors.forename: Paul
authors.initials: P
authors.lastname: Bowie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D058005:General Practitioners / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D058996:Quality Improvement / Q000458:organization & administration*; D012308:Risk Management / Q000458:organization & administration*; D012606:Scotland; D011795:Surveys and Questionnaires; D055815:Young Adult