Measurement and monitoring of safety:Impact and challenges of putting a conceptual framework into practice

Chatburn, Eleanor ORCID: https://orcid.org/0000-0002-6745-6737, Macrae, Carl, Carthey, Jane and Vincent, Charles (2018) Measurement and monitoring of safety:Impact and challenges of putting a conceptual framework into practice. BMJ Quality and Safety, 27 (10). pp. 827-835. ISSN 2044-5415

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Abstract

Background The Measurement and Monitoring of Safety Framework provides a conceptual model to guide organisations in assessing safety. The Health Foundation funded a large-scale programme to assess the value and impact of applying the Framework in regional and frontline care settings. We explored the experiences and reflections of key participants in the programme. Methods The study was conducted in the nine healthcare organisations in England and Scotland testing the Framework (three regional improvement bodies, six frontline settings). Post hoc interviews with clinical and managerial staff were analysed using template analysis. Findings Participants reported that the Framework promoted a substantial shift in their thinking about how safety is actively managed in their environment. It provided a common language, facilitated a more inquisitive approach and encouraged a more holistic view of the components of safety. These changes in conceptual understanding, however, did not always translate into broader changes in practice, with many sites only addressing some aspects of the Framework. One of the three regions did embrace the Framework in its entirety and achieved wider impact with a range of interventions. This region had committed leaders who took time to fully understand the concepts, who maintained a flexible approach to exploring the utility of the Framework and who worked with frontline staff to translate the concepts for local settings. Conclusions The Measuring and Monitoring of Safety Framework has the potential to support a broader and richer approach to organisational safety. Such a conceptually based initiative requires both committed leaders who themselves understand the concepts and more time to establish understanding and aims than might be needed in a standard improvement programme.

Item Type: Article
Additional Information: Funding Information: Acknowledgements We thank The Health Foundation for supporting this work. We thank all the participants who gave up their time so generously to be interviewed and the programme leads who facilitated the data collection. We are grateful to the associate editor and two anonymous reviewers for their very helpful feedback on an earlier version of this paper. Funding Information: Funding This study was funded by The Health Foundation. Competing interests JC runs workshops on the Measurement and Monitoring of Safety Framework. Provenance and peer review Not commissioned; externally peer reviewed. Open access This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Publisher Copyright: © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Uncontrolled Keywords: patient safety,qualitative research,quality measurement,safety culture,health policy,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2719
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: LivePure Connector
Date Deposited: 10 Nov 2022 12:33
Last Modified: 19 Oct 2023 03:28
URI: https://ueaeprints.uea.ac.uk/id/eprint/89757
DOI: 10.1136/bmjqs-2017-007175

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