Patient safety systems in the primary health care of diabetes—a story of missed opportunities?
OBJECTIVE
Key elements of a patient safety system include mechanisms for identifying errors or safety events, methods for investigating the events and processes for acting on the findings of the investigations. A patient safety system for management of diabetes in primary care might help to reduce adverse outcomes. The aims of this study were to review the current state of research into patient safety systems for people with diabetes in primary care.


METHODS
MEDLINE, EMBASE and nine other biomedical and health management databases were searched for articles published up to April 2009. Selection and review of abstracts were carried out independently by two authors.


RESULTS
Abstracts of 1659 articles were identified, of which only three fulfilled the selection criteria, and these did not appear in mainstream primary care journals. These papers covered the applications of root cause analysis, videoconferencing and automated telephone support to patient safety systems for managing diabetes in primary care.


CONCLUSIONS
There is very little evidence on how patient safety systems for the management of primary care diabetes can be implemented, or on how the effectiveness of such systems can be maximized. If patient safety systems do have potential to improve the processes and outcomes of care, the lack of relevant research may be regarded as a missed opportunity—investigation into the reasons for the situation is needed, with the aim of motivating and enabling further research on a range of problems identified here.
National Institute of Health Research Collaboration for Leadership in Applied Research and Care for Leicestershire, Northamptonshire and Rutland, Department of Health Sciences, University of Leicester, 22-28 Princess Road West, Leicester, UK. nick.taub@leicester.ac.uk
N
N
Taub
R
R
Baker
K
K
Khunti
J
J
Camosso-Stefinovic
R L
RL
Mehta
C L
CL
Weston
A G
AG
Mainous
D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards*