1st Edition

Safety and Improvement in Primary Care The Essential Guide

By Paul Bowie, Carl De Wet Copyright 2014

    'In recent decades most of the international effort given over to studying and improving the safety of patient care has been focused in acute hospital settings. To some extent this was always something of a puzzle to those of us with a direct interest in this important issue...Now, however, the tide is slowly turning. Policymakers, healthcare leaders and research grant funders are beginning to recognise that greater evidence is required to understand more about what can and does go wrong in primary care, with increasing attention now being paid to what can be done to minimise avoidable harm to patients in this setting.' From the Preface This remarkable new book represents a substantial body of work - led by key educators and researchers - devoted to learning about and improving the safety of primary healthcare. It offers highly practical guidance and evidence for a broad range of related improvement methods, concepts and interventions developed and implemented by the NES primary care team, or as a direct result of fruitful partnerships between academic, professional, public or regulatory institutions across the UK and internationally. Skillfully presented, the book is organised into five interlinked parts, each with a number of related chapters. Safety and Improvement in Primary Care: The Essential Guide is ideal for frontline clinicians, managers and healthcare administrators needing practical guidance on safety and is also highly recommended for improvement advisers, patient safety officers, clinical governance facilitators, risk managers, and health services researchers wanting a critical review of theory and evidence.

    Foreword. Preface. About the editors. List of contributors. Acknowledgements. Dedication. Prologue. Part I: Understanding systems. The heart of the matter: a parent's perspective. Improvement strategies and challenges. Safety culture. The wisdom hierarchy. Measuring harm systems thinking. Task analysis. Process mapping. Policies, procedures and protocols. Patient and public involvement - Part 1. Part II: People and improvement. Patient and public involvement - Part 2. Clinician engagement. Professionalism. Peer review. Professional appraisal. Multi-source feedback. General practice management. General practice nursing. Part III: Learning for improvement. Safety skills. Safety checklist for GP training. Practice-based small group learning. Protected learning time. Consultation skills. The power of apology. Part IV: Managing patient safety. Managing human error. Diagnostic error. Medication error. Medicines reconciliation: a case study. Safe results handling. Never events. Part V: Improvement methods. Enhanced significant event analysis. Criterion audit. Care bundles. The plan-do-study-act method. The trigger review method. Measuring safety climate improving out-of-hours care. Care improvement: a personal reflection. Index.


    PAUL BOWIE PhD FRCPE Programme Director for Safety and Improvement,NHS Education for Scotland, Glasgow, Scotland, UK. CARL DE WET, MBChB DRCOG MRCGP MMed(Fam), General Practitioner, Associate Adviser in Postgraduate GP Education, NHS Education for Scotland, Glasgow, Scotland, UK