In France, improving the practice of health professionals working in coordinated primary care teams (health centres called Maisons de Santé Pluriprofessionnelles - MSPs) could be facilitated by a learning system consisting of (i) a risk management support programme and (ii) the provision of a comprehensive online system combining training, reporting and support for the analysis and management of patient safety incidents (PSIs). EVIDENS-Prim is a multi-method, multi-centre, prospective study. It aims to describe the PSIs that occur in MSPs, using an international classification system, and to describe the ways in which professionals have adopted a global approach to PSIs management, from PSI reporting to feedback.
This method combines: \- (i) A sequential study of PSIs analysis. The sequential study will take place in three stages (coder training, collection of PSIs data via the web platform, PSIs coding). Each PSIs reported by professionals during the implementation of the risk management support programme will be coded using the PISA multi-axial classification system (based on the WHO's International Classification for Patient Safety in Primary Care). These codes will be used to describe PSIs in coordinated practice. \- (ii) An implementation study of the learning system. The learning system is described in the intervention section. During the implementation study, two types of data collection (quantitative and qualitative) will be mobilised at the end of the support to the QualiREL Santé Regional Support Structure. The main objective of the study is: \- To Describe PSIs occurring in MSPs as part of the coordinated exercise and over an 18-month period, according to the 4 coding frameworks of the PISA classification: (i) types of events (main and contributing), (ii) contributing factors, (iii) outcomes of PSIs, (iv) severity of harm. The secondary objectives, linked to the evaluation of the implementation of the learning system, are * To examine the acceptance of the learning system by the teams, * To describe the effective use of the web platform by professionals, * To describe the MSP's ownership of the risk management support programme.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
15
MSPs benefit from a learning system. The learning system combines an individualised support programme provided by a regional support structure for quality and safety in health care (QualiREL Santé) and the provision of a web platform. Based on the 4 dimensions of the Shortell model, the support programme includes initial training (6 months) and personalised methodological support (18 months) for each MSP. A web platform is provided to MSPs to enable them to implement the full approach of the Risk Management Support Programme. It provides support for reporting, analysis and management of PSIs.
Distribution of PSIs occurring in MSPs according to the 4 coding frameworks of the PISA classification: 1-by type
Repartition, according to the PISA classification, of PSIs reported by MSP professionals in the 18 months following the initial training provided, by type: the number of PSIs for each type out of the total number of PSIs reported.
Time frame: PSIs reported by MSP professionals in the 18 months following the initial training provided
Distribution of PSIs occurring in MSPs according to the 4 coding frameworks of the PISA classification: 2- by contributing factors
Repartition, according to the PISA classification, of PSIs reported by MSP professionals in the 18 months following the initial training provided, by contributing factors : number of PSIs for each contributing factor (e.g. factors related to the patient, staff, equipment, organisation, etc.) out of the total number of PSIs reported.
Time frame: 18 months
Distribution of PSIs occurring in MSPs according to the 4 coding frameworks of the PISA classification: 3-by results
Repartition, according to the PISA classification, of PSIs reported by MSP professionals in the 18 months following the initial training provided, by results: number of PSIs for each result (no harm, clinical harm, team harm) out of the total number of PSIs reported.
Time frame: 18 months
Distribution of PSIs occurring in MSPs according to the 4 coding frameworks of the PISA classification: 4-by severity
Repartition, according to the PISA classification, of PSIs reported by MSP professionals in the 18 months following the initial training provided, by severity: number of PSIs of each severity (e.g. no harm, mild, moderate or severe harm, death) out of the total number of PSIs reported.
Time frame: 18 months
Description of MSP professionals' acceptance of learning system
Analysis of the main themes and sub-themes of the acceptability of the learning system from the semi-directed interviews and focus groups conducted with MSP professionals.
Time frame: 3 months
Description of the behaviour of users of the online system in the 18 months following the provision of initial training
Export from the web platform of * the number of professionals who have validated the opening of their account on the web platform, * the number of professionals who have declared at least one PSI, * the number of modifications made to the PSIs declaration, * the number of declarations in anonymous mode, * the number of updates of action sheets corresponding to improvement actions.
Time frame: 18 months
Description of the MSP's behaviour in implementing the risk management support programme during the 18 months following the provision of the initial training.
Description: Export from the web platform of * the number of PSI declarations * the number of systemic analyses of PSIs carried out, * the number of types of contributing factors identified by the analysis (variable categories defined according to the analysis methods), * the number of analyses identifying security barriers (by type: present and effective / present and ineffective / absent), * the number of improvement actions planned / completed / abandoned.
Time frame: 18 months
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