Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis
Background The implementation and continuous improvement of patient safety learning systems (PSLS) is a principal strategy for mitigating preventable harm to patients. Although substantial efforts have sought to improve these systems, there is a need to more comprehensively understand critical succe...
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/2/e002134.full |
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| author | Alan J Forster Kednapa Thavorn Sunita Mulpuru Daniel McIsaac Hassan Assem Mahmoud Mohamed A Abdelrazek Amr Assem Mahmoud |
| author_facet | Alan J Forster Kednapa Thavorn Sunita Mulpuru Daniel McIsaac Hassan Assem Mahmoud Mohamed A Abdelrazek Amr Assem Mahmoud |
| author_sort | Alan J Forster |
| collection | DOAJ |
| description | Background The implementation and continuous improvement of patient safety learning systems (PSLS) is a principal strategy for mitigating preventable harm to patients. Although substantial efforts have sought to improve these systems, there is a need to more comprehensively understand critical success factors. This study aims to summarise the barriers and facilitators perceived by hospital staff and physicians to influence the reporting, analysis, learning and feedback within PSLS in hospitals.Methods We performed a systematic review and meta-synthesis by searching MEDLINE (Ovid), EMBASE (Ovid), CINAHL, Scopus and Web of Science. We included English-language manuscripts of qualitative studies evaluating effectiveness of the PSLS and excluded studies evaluating specific individual adverse events, such as systems for tracking only medication side effects, for example. We followed the Joanna Briggs Institute methodology for qualitative systematic reviews.Results We extracted data from 22 studies, after screening 2475 for inclusion/exclusion criteria. The included studies focused on reporting aspects of the PSLS, however, there were important barriers and facilitators across the analysis, learning and feedback phases. We identified the following barriers for effective use of PSLS: inadequate organisational support with shortage of resources, lack of training, weak safety culture, lack of accountability, defective policies, blame and a punitive environment, complex system, lack of experience and lack of feedback. We identified the following enabling factors: continuous training, a balance between accountability and responsibility, leaders as role models, anonymous reporting, user-friendly systems, well-structured analysis teams, tangible improvement.Conclusion Multiple barriers and facilitators to uptake of PSLS exist. These factors should be considered by decision makers seeking to enhance the impact of PSLS.Ethics and dissemination No formal ethical approval or consent were required as no primary data were collected. |
| format | Article |
| id | doaj-art-da37fc8f1c1b41718aec30e036a89055 |
| institution | OA Journals |
| issn | 2399-6641 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-da37fc8f1c1b41718aec30e036a890552025-08-20T01:57:55ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-06-0112210.1136/bmjoq-2022-002134Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesisAlan J Forster0Kednapa Thavorn1Sunita Mulpuru2Daniel McIsaac3Hassan Assem Mahmoud4Mohamed A Abdelrazek5Amr Assem Mahmoud62 Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaICES University of Ottawa, Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada1 Division of Respirology, The Ottawa Hospital, Toronto, Ontario, CanadaAnesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, CanadaPublic Health, Canadian Red Cross, Ottawa, Ontario, CanadaRadiology Department, London Health Sciences Centre, London, Ontario, CanadaPublic Health and Community Medicine, Cairo University Kasr Alainy Faculty of Medicine, Cairo, EgyptBackground The implementation and continuous improvement of patient safety learning systems (PSLS) is a principal strategy for mitigating preventable harm to patients. Although substantial efforts have sought to improve these systems, there is a need to more comprehensively understand critical success factors. This study aims to summarise the barriers and facilitators perceived by hospital staff and physicians to influence the reporting, analysis, learning and feedback within PSLS in hospitals.Methods We performed a systematic review and meta-synthesis by searching MEDLINE (Ovid), EMBASE (Ovid), CINAHL, Scopus and Web of Science. We included English-language manuscripts of qualitative studies evaluating effectiveness of the PSLS and excluded studies evaluating specific individual adverse events, such as systems for tracking only medication side effects, for example. We followed the Joanna Briggs Institute methodology for qualitative systematic reviews.Results We extracted data from 22 studies, after screening 2475 for inclusion/exclusion criteria. The included studies focused on reporting aspects of the PSLS, however, there were important barriers and facilitators across the analysis, learning and feedback phases. We identified the following barriers for effective use of PSLS: inadequate organisational support with shortage of resources, lack of training, weak safety culture, lack of accountability, defective policies, blame and a punitive environment, complex system, lack of experience and lack of feedback. We identified the following enabling factors: continuous training, a balance between accountability and responsibility, leaders as role models, anonymous reporting, user-friendly systems, well-structured analysis teams, tangible improvement.Conclusion Multiple barriers and facilitators to uptake of PSLS exist. These factors should be considered by decision makers seeking to enhance the impact of PSLS.Ethics and dissemination No formal ethical approval or consent were required as no primary data were collected.https://bmjopenquality.bmj.com/content/12/2/e002134.full |
| spellingShingle | Alan J Forster Kednapa Thavorn Sunita Mulpuru Daniel McIsaac Hassan Assem Mahmoud Mohamed A Abdelrazek Amr Assem Mahmoud Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis BMJ Open Quality |
| title | Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis |
| title_full | Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis |
| title_fullStr | Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis |
| title_full_unstemmed | Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis |
| title_short | Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis |
| title_sort | barriers and facilitators to improving patient safety learning systems a systematic review of qualitative studies and meta synthesis |
| url | https://bmjopenquality.bmj.com/content/12/2/e002134.full |
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