Table 3.
Summary of included systematic reviews
| Authors | Year | # articles | Aim of review | Summary of findings |
|---|---|---|---|---|
| All safety measures | ||||
| Hatoun et al. [18] | 2017 | 21 | To identify published articles detailing safety measures applicable to adult primary care | – Although numerous measures of patient safety exist, many are not validated and pertain only to a particular research study or quality improvement project |
| Lawati et al. [19] | 2018 | 28 | To review the literature on the safety culture and patient safety measures used globally | – The most common theme emerging from 2011 onwards was the assessment of safety culture – The most commonly used safety culture assessment tool was the Hospital Survey on Patient Safety Culture |
| Lydon et al. [15] | 2017 | 56 | To identify and review articles that presented or described the use of measures of patient safety suitable for use in general practice settings | – There is a need to improve the psychometric properties of existing tools as opposed to developing new tools – There is a need to take a multi-methods approach to assessing patient safety |
| Marchon and Mendes [16] | 2014 | 33 | To identify methodologies to evaluate incidents in primary health care, types of incidents, contributing factors and solutions to make primary care safer | – Highlighted the need for expanding safety culture in primary care in order to prepare patients and health professionals to identify and manage adverse events |
| Safety climate measures only | ||||
| Curran et al. [24] | 2018 | 17 | To identify the origins, psychometric properties, quality and safety climate domains measured by survey instruments used to assess safety climate in primary care settings | – Consideration should be given to selecting an instrument that has safety climate domains relevant to primary care – Need to focus on further establishing the criterion-related validity of existing surveys, rather than creating new surveys – Questionnaire with the most evidence of validity and reliability: PC SafeQuest, Frankfurt Patient Safety Climate Questionnaire and SCOPE |
| Desmedt et al. [26] | 2018 | 14 | To give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of these instruments | – A standard and widely validated survey is needed to increase generalizability and comparability – The SCOPE-PC survey is the most appropriate instrument to assess patient safety culture in primary care – There is a need to consider the triangulation of qualitative and quantitative methods to attain an in-depth assessment of culture |
| Madden et al. [27] | 2020 | 44 (10)a | To identify patient-reported safety climate measures described in the literature and make recommendations for best practice | – Few measures reported satisfactory levels of validity, reliability or usability measurement – Few measures are specifically designed for measuring the attitudes of primary care patients – There is value in using a mixed-methods approach to measuring patient safety |
| Vasconcelos et al. [25] | 2018 | 18 | To conduct an investigation of the tools used to assess safety culture in primary care | – In addition to reliability, other measures of validity are needed to establish the credibility of an instrument. Research addressing other types of psychometric tests is needed – The domains of communication, management perception and teamwork were present in all instruments. Future research on patient safety should incorporate these attributes |
| Reporting systems only | ||||
| King et al. [22] | 2010 | 17 (5)a | To identify the state of the art in patient reporting systems used in research studies | – When designing a reporting tool, it should be evaluated in the local setting to ensure appropriate terminology is used. International terminology standards should be adopted. Reports from patients should be actively solicited |
| Ricci-Cabello et al. [23] | 2015 | 28 | To identify and characterize available patient-reported instruments to measure patient safety in primary care | – Taxonomies for classifying errors and harm were not consistently used for developing the instruments, impairing the ability to make comparisons – There was a lack of valid and reliable instruments specifically designed to provide a comprehensive measurement of the safety of care provided in primary care practices |
| Patient record review only | ||||
| Davis et al. [17] | 2018 | 15 | To understand the ability of trigger tools to detect preventable adverse events in the primary care outpatient setting | – Outcome measures were heterogenous, precluding the ability to quantitatively compare the studies |
| Madden et al. [20] | 2018 | 15 | This review aimed to synthesize the literature describing the use of patient record review to measure and improve patient safety in primary care | – Studies using trigger tool methodologies tended to detect higher incidences of PSIs, suggesting greater empirical support than other methods – Need to refine and standardize the methods used in patient record review to improve consistency and validity and facilitate ease of comparison across studies – Strong rationale for combining more than one method of studying patient safety |
| Tsang et al. [21] | 2012 | 15 | To determine the types of adverse events that are routinely recorded in primary care | – Measurement of primary care adverse events was often based on secondary care data in conjunction with other clinical and non-clinical information. This use of multiple data sources will enhance the accuracy of measurements and compensate weaknesses inherent to individual data types – Greater attention required on developing indicators and other measures that take advantage of the available IT resources to improve quality and safety |
a
Number in brackets is the number of included studies focused on primary care.