title: Patient Safety Policy in Long-Term Care: A Research Protocol to Assess Executive WalkRounds to Improve Management of Early Warning Signs for Patient Safety.
abstract: BACKGROUND
  At many hospitals and long-term care organizations (such as nursing homes), executive board members have a responsibility to manage patient safety. Executive WalkRounds offer an opportunity for boards to build a trusting relationship with professionals and seem useful as a leadership tool to pick up on soft signals, which are indirect signals or early warnings that something is wrong. Because the majority of the research on WalkRounds has been performed in hospitals, it is unknown how board members of long-term care organizations develop their patient safety policy. Also, it is not clear if these board members use soft signals as a leadership tool and, if so, how this influences their patient safety policies.
  
  
  OBJECTIVE
  The objective of this study is to explore the added value and the feasibility of WalkRounds for patient safety management in long-term care. This study also aims to identify how executive board members of long-term care organizations manage patient safety and to describe the characteristics of boards.
  
  
  METHODS
  An explorative before-and-after study was conducted between April 2012 and February 2014 in 13 long-term care organizations in the Netherlands. After implementing the intervention in 6 organizations, data from 72 WalkRounds were gathered by observation and a reporting form. Before and after the intervention period, data collection included interviews, questionnaires, and studying reports of the executive boards. A mixed-method analysis is performed using descriptive statistics, t tests, and content analysis.
  
  
  RESULTS
  Results are expected to be ready in mid 2014.
  
  
  CONCLUSIONS
  It is a challenge to keep track of ongoing development and implementation of patient safety management tools in long-term care. By performing this study in cooperation with the participating long-term care organizations, insight into the potential added value and the feasibility of this method will increase.
authors.affiliation: Radboud University Medical Centre, Scientific Institute for Quality of Healthcare, Nijmegen, Netherlands. Loes.vanDusseldorp@radboudumc.nl.
authors.forename: Loes
authors.identifier: http://orcid.org/0000-0003-4803-4800
authors.initials: L
authors.lastname: van Dusseldorp
authors.forename: Hub
authors.identifier: http://orcid.org/0000-0001-9083-3679
authors.initials: H
authors.lastname: Hamers
authors.forename: Theo
authors.identifier: http://orcid.org/0000-0003-0111-6622
authors.initials: T
authors.lastname: van Achterberg
authors.forename: Lisette
authors.identifier: http://orcid.org/0000-0002-7129-3766
authors.initials: L
authors.lastname: Schoonhoven
keywords: governance, long-term care, executive board, patient safety, WalkRounds, soft signals