Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents.
BACKGROUND
Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety.


OBJECTIVE
The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence.


METHODS
The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA's design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions.


RESULTS
BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003).


CONCLUSIONS
BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use.
Health Psychology Department, Miguel Hernández University, Elche, Spain. icarrillo@umh.es.
Irene
http://orcid.org/0000-0002-6981-7284
I
Carrillo
José Joaquín
http://orcid.org/0000-0001-6497-083X
JJ
Mira
Maria Asuncion
http://orcid.org/0000-0002-8630-7251
MA
Vicente
Cesar
http://orcid.org/0000-0002-9391-9192
C
Fernandez
Mercedes
http://orcid.org/0000-0002-0706-9911
M
Guilabert
Lena
http://orcid.org/0000-0001-7180-4709
L
Ferrús
Elena
http://orcid.org/0000-0003-2562-0196
E
Zavala
Carmen
http://orcid.org/0000-0002-6034-4142
C
Silvestre
Pastora
http://orcid.org/0000-0001-8779-0591
P
Pérez-Pérez
frontline health professionals; hospital; middle managers; patient safety; primary care; risk management; root cause analysis
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