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Do older patients' perceptions of safety highlight barriers that could make their care safer during organisational care transfers?
  1. Jason Scott1,
  2. Pamela Dawson2,
  3. Diana Jones1
  1. 1Faculty of Health and Life Sciences, School of Health, Community and Education Studies, Northumbria University, Newcastle upon Tyne, UK
  2. 2York St John University, York, UK
  1. Correspondence to Dr Diana Jones, School of Health, Community and Education Studies, Northumbria University, Coach Lane Campus East, Newcastle upon Tyne NE7 7XA, UK; anna.jones{at}northumbria.ac.uk

Abstract

Background Healthcare is a series of complex, interwoven systems in which any discontinuities of care may affect the safety of patients, who have been reported to perceive safety differently to clinicians. This study aimed to explore patient perceptions of safety and identify how they can be used to construct additional barriers to reduce safety incidents within organisational care transfers, which are known to be high in risk.

Design Appreciative Inquiry (AI) methodology was used to develop semi-structured interviews, using the Discover and Dream processes of AI. Fourteen patients (four men, 10 women; average age 76.2 years) were purposively recruited from NHS community care teams, social care homes and private nursing homes based on their experience of going through organisational care transfers. Thematic analysis was used to highlight key themes, which participants verified.

Findings Communication, responsiveness and avoidance of traditional safety risks were identified as being important for patients to feel safe. Communication and responsiveness were mapped onto the Swiss-Cheese model of safety, presenting two new barriers to safety incidents. Traditional risks and the role of trust are discussed in relation to patients feeling safe.

Conclusion Perceptions of safety such as communication and responsiveness were similar to those found in previous studies. Mapping these perceptions onto the Swiss-Cheese model of safety identifies how further defences, barriers and safeguards can be constructed to make people feel safer by reinforcing communication and responsiveness. Traditional risks are widely published, but the identification by patients reinforces the role they can play in identifying and reporting these risks.

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Footnotes

  • Funding The study was co-funded by Northumbria University and the North East Strategic Health Authority.

  • Competing interests None.

  • Ethics approval Sunderland Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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