A framework for classifying patient safety practices: results from an expert consensus process
Abstract
Objective: Development of a coherent literature evaluating patient safety practices has been hampered by the lack of an underlying conceptual framework. The authors describe issues and choices in describing and classifying diverse patient safety practices (PSPs). Methods: The authors developed a framework to classify PSPs by identifying and synthesising existing conceptual frameworks, evaluating the draft framework by asking a group of experts to use it to classify a diverse set of PSPs and revising the framework through an expert-panel consensus process. Results: The 11 classification dimensions in the framework include: regulatory versus voluntary; setting; feasibility; individual activity versus organisational change; temporal (one-time vs repeated/long-term); pervasive versus targeted; common versus rare events; PSP maturity; degree of controversy/conflicting evidence; degree of behavioural change required for implementation; and sensitivity to context. Conclusion: This framework offers a way to classify and compare PSPs, and thereby to interpret the patient-safety literature. Further research is needed to develop understanding of these dimensions, how they evolve as the patient safety field matures, and their relative utilities in describing, evaluating and implementing PSPs.
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Using a consensus process to expand one of the existing frameworks used by the group was considered not to be feasible on the basis of a review of two studies of definitions of quality improvement interventions.
“This type of consensus was considered not to be feasible on the basis of a review of two studies of definitions of quality improvement (QI) interventions.”
From Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies (2014) · cites this paper as [28]
A follow-up study found that subjective interpretation of constructs, difficulty measuring constructs, heterogeneity in published papers, and poor reporting of QI prevented the achievement of consensus on classifying QI interventions.
“A follow-up study aimed to develop definitional features of continuous quality improvement (CQI) [28] but found that subjective interpretation of constructs, difficulty measuring constructs, heterogeneity in published papers, and poor reporting of QI prevented the achievement of consensus on classifying QI interventions [28].”
From Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies (2014) · cites this paper as [28]
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- Authors
- Dy, S. M., Taylor, S. L., Carr, L. H., Foy, R., Pronovost, P. J., Øvretveit, J., Wachter, R. M., Rubenstein, L. V., Hempel, S., McDonald, K. M., & Shekelle, P. G.
- Affiliations
- Johns Hopkins University (US)
- RAND Corporation (US)
- University of California, San Francisco (US)
- University of Leeds (GB)
- Karolinska Institutet (SE)
- Stanford University (US)
- Corresponding author
- Dy, Sydney M
- ORCID
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2011-05-24
- Volume
- 20
- Issue
- 7
- Pages
- 618-624
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- OpenAlex
- W2171593294
- Cited by
- 33
- References
- 14
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 2 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 6 · 2012: 2
- FWCI
- 6.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- patient safety measures, classification framework, conceptual framework, expert consensus, organizational change, implementation feasibility, behavior change, context sensitivity, literature synthesis
- MeSH terms
- Attitude of Health Personnel, Communication, Cooperative Behavior, Humans, Inservice Training, Patient Care Team, Policy Making, Quality of Health Care, Organizational Culture, Safety Management, Consensus, Policy
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