Qualité des soins primaires Libre accès

Abstrait

Barriers to signiŽcant event analysis: an attitudinal survey of principals in general practice

John McKay

Background SigniŽ cant event analysis (SEA) is a qualitative method of audit which allows healthcare teams to discuss speciŽ c events considered to be ‘signiŽ cant’ in a formal and structured manner. Its use can potentially facilitate re? ective learningand improve patient care and safety. There is pressure on general practitioners (GPs) to participate in SEA for various organisational and professional reasons, including revalidation. It is assumed that they possess the inherent abilities toperform this activity. However, there is limited knowledge about the attitudes of GPs towards SEA and any potential barriers to participation.Aim To determine any perceived barriers to and beliefs about identifying and analysing signiŽ cant events.Method Cross-sectional questionnaire survey of 617 GPs in Greater Glasgow.Results A 76% response rate was achieved; 41% of respondents agreed it can be di¤cult to determine when an event is signiŽ cant. In addition, 26% were uncertain how to analyse a signiŽ cant event, 59% agreed there is a lack of time to discuss signiŽ cantevents, while 20% would require training in SEA. Fewer training practice respondents were in agreement with these attitudinal statements than colleagues from non-training practices (P 0.001). Only 4% of GPs found SEA to be threatening, while 76% agreed it should be part of revalidation. Less experienced GPs were more likely to agree it can be di¤cult to determinewhen an event is signiŽ cant (P = 0.008) and that they sometimes avoid dealing with events because of the complexity involved (P = 0.01).Conclusions The Ž ndings showed that GPs are generally positive about the SEA technique and its inclusion as part of revalidation. However, educational issues have been raised for a number of GPs in terms of their current ability to identify asigniŽ cant event and perform a structured analysis, which may have implications for the reporting of adverse incidents, appraisal and the clinical governance agenda