title: Patient involvement in patient safety: Protocol for developing an intervention using patient reports of organisational safety and patient incident reporting.
abstract: BACKGROUND
  Patients have the potential to provide a rich source of information on both organisational aspects of safety and patient safety incidents. This project aims to develop two patient safety interventions to promote organisational learning about safety - a patient measure of organisational safety (PMOS), and a patient incident reporting tool (PIRT) - to help the NHS prevent patient safety incidents by learning more about when and why they occur.
  
  
  METHODS
  To develop the PMOS 1) literature will be reviewed to identify similar measures and key contributory factors to error; 2) four patient focus groups will ascertain practicality and feasibility; 3) 25 patient interviews will elicit approximately 60 items across 10 domains; 4) 10 patient and clinician interviews will test acceptability and understanding. Qualitative data will be analysed using thematic content analysis.To develop the PIRT 1) individual and then combined patient and clinician focus groups will provide guidance for the development of three potential reporting tools; 2) nine wards across three hospital directorates will pilot each of the tools for three months. The best performing tool will be identified from the frequency, volume and quality of reports. The validity of both measures will be tested. 300 patients will be asked to complete the PMOS and PIRT during their stay in hospital. A sub-sample (N = 50) will complete the PMOS again one week later. Health professionals in participating wards will also be asked to complete the AHRQ safety culture questionnaire. Case notes for all patients will be reviewed. The psychometric properties of the PMOS will be assessed and a final valid and reliable version developed. Concurrent validity for the PIRT will be assessed by comparing reported incidents with those identified from case note review and the existing staff reporting scheme. In a subsequent study these tools will be used to provide information to wards/units about their priorities for patient safety. A patient panel will provide steering to the research.
  
  
  CONCLUSIONS
  The PMOS and PIRT aim to provide a reliable means of eliciting patient views about patient safety. Both interventions are likely to have relevance and practical utility for all NHS hospital trusts.
authors: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK. jane.ward@bradfordhospitals.nhs.uk
authors: Jane K
authors: JK
authors: Ward
authors: Rosemary R C
authors: RR
authors: McEachan
authors: Rebecca
authors: R
authors: Lawton
authors: Gerry
authors: G
authors: Armitage
authors: Ian
authors: I
authors: Watt
authors: John
authors: J
authors: Wright
references: Qual Saf Health Care. 2006 Dec;15 Suppl 1:i50-8
references: 17142610
references: J Gen Intern Med. 1995 Apr;10(4):199-205
references: 7790981
references: Nurse Educ Pract. 2008 Sep;8(5):299-301
references: 18692016
references: Health Serv Res. 2005 Dec;40(6 Pt 2):2018-36
references: 16316436
references: Qual Saf Health Care. 2002 Mar;11(1):76-80
references: 12078376
references: Qual Saf Health Care. 2008 Apr;17(2):90-6
references: 18385400
references: Health Expect. 2007 Sep;10(3):259-67
references: 17678514
references: Int J Qual Health Care. 2002 Dec;14(6):471-82
references: 12515333
references: Qual Saf Health Care. 2010 Dec;19(6):e2
references: 20511598
references: Qual Saf Health Care. 2008 Jun;17(3):216-23
references: 18519629
references: J Eval Clin Pract. 2010 Dec;16(6):1189-97
references: 20807298
references: Qual Saf Health Care. 2007 Feb;16(1):45-50
references: 17301205
references: Br J Gen Pract. 2007 Sep;57(542):737-40
references: 17761061
references: Jt Comm J Qual Patient Saf. 2005 Sep;31(9):483-94
references: 16255326
references: N Engl J Med. 1991 Feb 7;324(6):370-6
references: 1987460
references: Health Serv Res. 2005 Dec;40(6 Pt 2):1996-2017
references: 16316435
references: J Qual Clin Pract. 1998 Sep;18(3):199-211
references: 9744659
references: BMJ. 2001 Mar 3;322(7285):517-9
references: 11230064
references: Qual Saf Health Care. 2010 Apr;19(2):148-57
references: 20351164
references: J Eval Clin Pract. 2005 Oct;11(5):479-83
references: 16164589
references: Med Care Res Rev. 2010 Apr;67(2):119-48
references: 19671916
references: J Health Psychol. 2007 Jul;12(4):672-87
references: 17584818
references: J Gen Intern Med. 2006 Apr;21(4):367-70
references: 16686815
references: Ann Intern Med. 2008 Jul 15;149(2):100-8
references: 18626049
references: Qual Saf Health Care. 2010 Dec;19(6):e33
references: 21127092
references: Qual Saf Health Care. 2010 Oct;19(5):e10
references: 20427301
references: Int J Qual Health Care. 2007 Apr;19(2):60-7
references: 17277013
references: Health Policy. 2009 Apr;90(1):1-7
references: 18829130
references: BMJ. 2007 Jan 13;334(7584):79
references: 17175566
references: Mayo Clin Proc. 2010 Jan;85(1):53-62
references: 20042562
references: Pharmacoepidemiol Drug Saf. 2009 Nov;18(11):992-9
references: 19634116
references: JAMA. 2001 Apr 25;285(16):2114-20
references: 11311101
references: Jt Comm J Qual Patient Saf. 2007 Feb;33(2):83-94
references: 17370919
references: Health Serv Res. 2005 Dec;40(6 Pt 2):1977-95
references: 16316434
references: Int J Med Inform. 2007 Jun;76 Suppl 1:S236-44
references: 16829180
references: Aust Health Rev. 2009 Aug;33(3):390-9
references: 20128754
references: Health Expect. 2006 Sep;9(3):205-6
references: 16911134
references: N Engl J Med. 1991 Feb 7;324(6):377-84
references: 1824793
references: J Gen Intern Med. 2005 Sep;20(9):830-6
references: 16117751
references: Qual Saf Health Care. 2008 Apr;17(2):101-3
references: 18385402