Evidence map›Paper›PMID 34405231›Full record

SynthesisInternational journal for quality in health care : journal of the International Society for Quality in Health Care2021

A meta-review of methods of measuring and monitoring safety in primary care.

Paul O'Connor, Caoimhe Madden, Emily O'Dowd, Dara Byrne, SinÉad Lydon

Abstract readSystematic Review
In one paragraph

Synthesis in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Paul O'ConnorDiscipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.
Caoimhe MaddenDiscipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.ORCID 0000-0001-5542-7106
Emily O'DowdDiscipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.
Dara ByrneIrish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Co Galway H91 TK33, Ireland.
SinÉad LydonDiscipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.ORCID 0000-0001-5700-4350

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA major barrier to safety improvement in primary care is a lack of safety data. The aims of this systematic meta-review (registration: CRD42021224367) were to identify systematic reviews of studies that examine methods of measuring and monitoring safety in primary care; classify the methods of measuring and monitoring safety in the included systematic reviews using the five safety domains of Vincent et al.'s framework and use this information to make recommendations for improving the measurement and monitoring of safety in primary care.

methodsFour databases (Medline, Academic Search Complete, Web of Science and CINAHL) and the grey literature were screened in November 2020, with searches updated in January 2021. Systematic reviews were included if they addressed the measurement of patient safety in primary care and were published in English. Studies were assessed using the Critical Appraisal Skills Programme for systematic reviews.

resultsA total of 6904 papers were screened, with 13 systematic reviews included. A commonly reported method of measuring 'past harm' was through patient record review. The most frequent methods for assessing the 'reliability of safety critical processes' were checklists, observations and surveys of staff. Methods used to assess 'sensitivity to operations' included observation, staff surveys, interviews, focus groups, active monitoring and simulated patients. Safety climate surveys were a commonly used as an approach to assess 'anticipation and preparedness'. A number of the reviews concluded that safety data could, and should, be used for 'integration and learning'. The main limitation of the meta-review was that it was of systematic reviews only.

conclusionsMany of the methods for measuring and monitoring safety are readily available, quick to administer, do not require external involvement and are inexpensive. However, there is still a need to improve the psychometric properties of many measures. Researchers must support the development of psychometrically sound safety measures that do not over burden primary care practitioners. Policymakers must consider how primary care practitioners can be supported to implement these measures.

Indexed as

Patient SafetyPrimary Health CareChecklistHumansReproducibility of ResultsSystematic Reviews as Topicmeasurementmeta-reviewmonitoringpatient safetyprimary care

Identifiers

PMID34405231
PMCPMC8397923

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.