Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.
BACKGROUND
There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture.


OBJECTIVE
To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care.


METHODS
Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care.


RESULTS
The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events.


CONCLUSIONS
Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care.
a University of Manchester and Safety Culture Associates Ltd , Manchester , UK.
Dianne
D
Parker
Michel
M
Wensing
Aneez
A
Esmail
Jose M
JM
Valderas
D019985:Benchmarking / Q000379:methods*; D005060:Europe; D006801:Humans; D015279:Organizational Culture; D061214:Patient Safety; D011320:Primary Health Care; D011795:Surveys and Questionnaires
LINNEAUS collaboration; measurement tools; patient safety culture; primary care; process indicators