Table 3.
Methods reported by participants to measure and monitor patient safety in Irish hospitals
| Dimension | No | Reported methods of measuring and monitoring safety | Number of participants reported the measure (no.) % | ||
|---|---|---|---|---|---|
| (18) 87.5% Front-line healthcare staff |
(6) 12.5% Policy makers |
(24) 100% All |
|||
| 1. Harm | 1. | Incident reporting systems | (15) 83.3% | (4) 66.6% | (19) 79.2% |
| 2. | National Incident Management System (NIMS) | - | (1) 16.6% | (1) 4.2% | |
| 3. | Hospital-acquired complications | - | (1) 16.6% | (1) 4.2% | |
| 4. | Hospital In-Patient Enquiry (HIPE) | - | (1) 16.6% | (1) 4.2% | |
| 5. | Mortality and morbidity rates | (5) 27.8% | - | (5) 20.8% | |
| 6. | Patient safety indicators | (1) 5.5% | - | (1) 4.2% | |
| 7. | Incidence of falls | (2) 11% | - | (2) 8.3% | |
| 8. | Pressure ulcer rates | (3) 16.7% | - | (3) 12.5% | |
| 9. | State Claims Agency | (1) 5.5% | - | (1) 4.2% | |
| 10. | Medication error reporting | (3) 16.7% | - | (3) 12.5% | |
| 11. | Rates of healthcare-associated infections (HCAIs) | (1) 5.5% | (1) 16.6% | (2) 8.3% | |
| 12. | Readmission rates | (1) 5.5% | - | (1) 4.2% | |
| 13. | Patient satisfaction surveys | - | (1) 16.6% | (1) 4.2% | |
| 14. | Patients’ complaint systems | (1) 5.5% | - | (1) 4.2% | |
| 2. Reliability of safety critical processes | 1. | Monitoring compliance to hand hygiene | (1) 5.5% | (2) 33.3% | (3) 12.5% |
| 2. | Observation of safety critical behaviours | (2) 11% | - | (2) 8.3% | |
| 3. | Monitoring national standards | (5) 27.8% | (1) 16.6% | (6) 25% | |
| 4. | National/international accreditation | (1) 5.5% | - | (1) 4.2% | |
| 5. | Inspections to monitor compliance against standards and guideline | (4) 22.2% | (1) 16.6% | (5) 20.8% | |
| 6. | Venous thromboembolism risk assessment | (1) 5.5% | - | (1) 4.2% | |
| 7. | Key performance indicators of patient safety goals | (3) 16.7% | (1) 16.6% | (4) 16.7% | |
| 8. | Audit of equipment | (6) 33.3% | - | (6) 25% | |
| 9. | Infection control checklists | (1) 5.5% | - | (1) 4.2% | |
| 10. | Clinical audit | (14) 77.8% | (4) 66.6% | (18) 75% | |
| 11. | Patient observation charts | (4) 22.2% | - | (4) 16.7% | |
| 12. | Double checks by other staff members | (7) 38.9% | - | (7) 29.2% | |
| 13. | Monitoring of vital signs | (1) 5.5% | - | (1) 4.2% | |
| 14. | Quality and safety monthly governance meeting | - | (1) 16.6% | (1) 4.2% | |
| 15. | Patient administration systems | - | (1) 16.6% | (1) 4.2% | |
| 16. | Specialty-specific data management systems | - | (1) 16.6% | (1) 4.2% | |
| 17. | Turnaround times (TAT) | - | (1) 16.6% | (1) 4.2% | |
| 18. | Early warning score | (6) 33.3% | (2) 33.3% | (8) 33.3% | |
| 19. | Armbands to identify patients at risk | (1) 5.5% | - | (1) 4.2% | |
| 20. | Surgical checklist | (3) 16.7% | - | (3) 12.5% | |
| 21. | Systems to check bed availability | (1) 5.5% | - | (1) 4.2% | |
| 22. | Preoperative assessment clinic | (1) 5.5% | - | (1) 4.2% | |
| 23. | Medication administration checklists | (1) 5.5% | - | (1) 4.2% | |
| 24. | Staff assessment and credentialling | (1) 5.5% | - | (1) 4.2% | |
| 25. | Monitoring delays in treatment | (1) 5.5% | - | (1) 4.2% | |
| 3. Sensitivity to operations | 1. | Safety walk-arounds | (5) 27.8% | (1) 16.6% | (6) 25% |
| 2. | Talking to patients | (3) 16.7% | - | (3) 12.5% | |
| 3. | Safety huddles | (4) 22.2% | (2) 33.3% | (6) 25% | |
| 4. | Briefings and debriefings | (2) 11% | - | (2) 8.3% | |
| 5. | Observation and conversations with clinical teams | (7) 38.9% | (1) 16.6% | (8) 33.3% | |
| 6. | Ward rounds and routine reviews of patients and working conditions | (2) 11% | - | (2) 8.3% | |
| 7. | Handover and handouts | (4) 22.2% | - | (4) 16.7% | |
| 8. | Real-time monitoring and feedback in anaesthesia | (1) 5.5% | - | (1) 4.2% | |
| 4. Anticipation and preparedness | 1. | Failure mode and effect analysis (FMEA) to identify risks | (1) 5.5% | - | (1) 4.2% |
| 2. | Staff assessment and credentialing | (3) 16.7% | - | (3) 12.5% | |
| 3. | Risk registers | - | (4) 66.6% | (4) 16.7% | |
| 4. | Anticipated staffing levels and skill mix | (7) 38.9% | - | (7) 29.2% | |
| 5. | Screening for embolism | (1) 5.5% | - | (1) 4.2% | |
| 6. | Timely safety alerts | - | (1) 16.6% | (1) 4.2% | |
| 7. | Comprehensive hazard identification risk assessment | - | (1) 16.6% | (1) 4.2% | |
| 8. | A hospital emergency management plan that is aligned with the city’s emergency management plan | - | (1) 16.6% | (1) 4.2% | |
| 9. | Comprehensive risk assessments of patient at admission | (4) 22.2% | - | (4) 16.7% | |
| 10. | Fall risk assessment | (1) 5.5% | - | (1) 4.2% | |
| 11. | Waterlow skin assessment | (2) 11% | - | (2) 8.3% | |
| 12. | Malnutrition Universal Screening Tool (MUST) | (2) 11% | - | (2) 8.3% | |
| 13. | Nursing pools | (1) 5.5% | - | (1) 4.2% | |
| 14. | Risk prediction scores in anaesthesia | (1) 5.5% | - | (1) 4.2% | |
| 15. | Preoperative assessment of patients | (2) 11% | - | (2) 8.3% | |
| 5. Integration and learning | 1. | Analysis of incidents and feedback leading to the implementation of safety lessons | (8) 44.4% | (4) 66.6% | (12) 50% |
| 2. | Learning from audits | (1) 5.5% | - | (1) 4.2% | |
| 3. | Learning from patient safety alerts | - | (1) 16.6% | (1) 4.2% | |
| 4. | Learning from patients’ complaints | (2) 11% | (1) 16.6% | (3) 12.5% | |
| 5. | Learning from meetings and discussion of sentinel events | (2) 11% | - | (2) 8.3% | |
| 6. | Debriefing sessions to provide feedback on clinical performance | (3) 16.7% | - | (3) 12.5% | |
| 7. | Learning from root cause analysis | (2) 11% | (1) 16.6% | (3) 12.5% | |
| 8. | Learning from excellence | - | (1) 16.6% | (1) 4.2% | |
| 9. | Learning reported in research papers from other health organisations | - | (2) 33.3% | (2) 8.3% | |
| 10. | learning from safety networks that involve local and national health agencies | (1) 5.5% | (2) 33.3% | (3) 12.5% | |
| 11. | After action reviews (AAR) | - | (1) 16.6% | (1) 4.2% | |
| 12. | Learning from international experience reported in the literature | - | (1) 16.6% | (1) 4.2% | |
| 13. | Simulation sessions following patient safety incidents | (5) 27.8% | - | (5) 20.8% | |
| 14. | Learning from mortality and morbidity reviews | (2) 11% | - | (2) 8.3% | |