title: Patient safety work in Sweden: quantitative and qualitative analysis of annual patient safety reports.
abstract: BACKGROUND
  There is widespread recognition of the problem of unsafe care and extensive efforts have been made over the last 15 years to improve patient safety. In Sweden, a new patient safety law obliges the 21 county councils to assemble a yearly patient safety report (PSR). The aim of this study was to describe the patient safety work carried out in Sweden by analysing the PSRs with regard to the structure, process and result elements reported, and to investigate the perceived usefulness of the PSRs as a tool to achieve improved patient safety.
  
  
  METHODS
  The study was based on two sources of data: patient safety reports obtained from county councils in Sweden published in 2014 and a survey of health care practitioners with strategic positions in patient safety work, acting as key informants for their county councils. Answers to open-ended questions were analysed using conventional content analysis.
  
  
  RESULTS
  A total of 14 structure elements, 31 process elements and 23 outcome elements were identified. The most frequently reported structure elements were groups devoted to working with antibiotics issues and electronic incident reporting systems. The PSRs were perceived to provide a structure for patient safety work, enhance the focus on patient safety and contribute to learning about patient safety.
  
  
  CONCLUSIONS
  Patient safety work carried out in Sweden, as described in annual PSRs, features a wide range of structure, process and result elements. According to health care practitioners with strategic positions in the county councils' patient safety work, the PSRs are perceived as useful at various system levels.
authors.affiliation: Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, SE-581 83, Linköping, Sweden.
authors.forename: Mikaela
authors.initials: M
authors.lastname: Ridelberg
authors.affiliation: Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, SE-581 83, Linköping, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Roback
authors.affiliation: Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83, Linköping, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Nilsen
authors.affiliation: Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83, Linköping, Sweden. siw.carlfjord@liu.se.
authors.forename: Siw
authors.initials: S
authors.lastname: Carlfjord
mesh_terms: D004282:Documentation; D006801:Humans; D061214:Patient Safety / Q000592:standards; D036301:Qualitative Research; D058996:Quality Improvement; D012308:Risk Management; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Healthcare; Patient safety; Patient safety reports