Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

A conceptual framework identifying sources of risk to patient safety in primary care

Logan McLeod A , JoAnn Kingston-Riechers B D and Egon Jonsson C
+ Author Affiliations
- Author Affiliations

A Department of Public Health Sciences, University of Alberta, 2-040 Li Ka Shing Centre for Health Research Innovation, Edmonton, AB T6G 2E1, Canada.

B Department of Economics, University of Alberta, Edmonton, AB T6G 2H1, Canada.

C Institute of Health Economics, 1200-10405 Jasper Avenue, Edmonton, AB T5J 3N4, Canada.

D Corresponding author. Email: joannk@ualberta.ca

Australian Journal of Primary Health 18(3) 185-189 https://doi.org/10.1071/PY11062
Submitted: 3 June 2011  Accepted: 26 October 2011   Published: 23 January 2012

Abstract

The potential risks to patient safety in a primary care setting are different than the risks to patient safety in an acute care setting. The main differences arise from the organisational structures of primary care delivery and the greater involvement of patients in their care. To account for these differences, we present the Patient Safety in Primary Care Framework to conceptualise the sources of risk to patient safety.


References

Adashi EY, Geiger HJ, Fine MD (2010) Health care reform and primary care - the growing importance of the community health center. The New England Journal of Medicine 362, 2047–2050.
Health care reform and primary care - the growing importance of the community health center.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXntVajt7c%3D&md5=f7662d770b93dc243484394c49a3d6e5CAS | 20427777PubMed |

Australian Commission on Safety and Quality in Health Care (2010) Patient safety in primary health care: discussion paper draft for public consultation. (Australian Commission on Safety and Quality in Health Care: Sydney) Available at http://www.health.gov.au/internet/safety/publishing.nsf/Content/B9CBDD0DA7EC8C88CA2573210022C464/$File/38689-DiscussionPaper.pdf [Verified 19 December 2011]

Bailey CJ, Kodack M (2011) Patient adherence to medication requirements for therapy of type 2 diabetes. International Journal of Clinical Practice 65, 314–322.

Booth BJ, Snowdon T, Harris MF, Tomlins R (2008) Safety and quality in primary care: the view from general practice. Australian Journal of Primary Health 14, 19–27.
Safety and quality in primary care: the view from general practice.Crossref | GoogleScholarGoogle Scholar |

Brekke M, Rognstad S, Straand J, Furu K, Gjelstad S, Bjorner T, Dalen I (2008) Pharmacologically inappropriate prescriptions for elderly patients in general practice: how common? Baseline data from The Prescription Peer Academic Detailing (Rx-PAD) study. Scandinavian Journal of Primary Health Care 26, 80–85.
Pharmacologically inappropriate prescriptions for elderly patients in general practice: how common? Baseline data from The Prescription Peer Academic Detailing (Rx-PAD) study.Crossref | GoogleScholarGoogle Scholar | 18570005PubMed |

Canadian Institutes of Health Research (2010) ‘CIHR roadmap signature initiative in community-based primary healthcare.’ Available at http://www.cihr-irsc.gc.ca/e/documents/fact_sheet_primary_care_e.pdf [Verified 19 December 2011]

Elder NC (2008) Quality and safety in outpatient laboratory testing. Clinics in Laboratory Medicine 28, 295–303.
Quality and safety in outpatient laboratory testing.Crossref | GoogleScholarGoogle Scholar | 18436072PubMed |

Elliott RA (2008) Poor adherence to medication in adults with rheumatoid arthritis: reasons and solutions. Disease Management and Health Outcomes 16, 13–29.

Fiscella K (2011) Health care reform and equity: promise, pitfalls, and prescriptions. Annals of Family Medicine 9, 78–84.
Health care reform and equity: promise, pitfalls, and prescriptions.Crossref | GoogleScholarGoogle Scholar | 21242565PubMed |

Gandhi TK, Kachalia A, Thomas EJ, Puopolo AL, Yoon C, Brennan TA, Studdert DM (2006) Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Annals of Internal Medicine 145, 488–496.

Health Canada (2010) ‘Health care system: about primary health care.’ (Government of Canada: Ottawa) Available at http://www.hc-sc.gc.ca/hcs-sss/prim/about-apropos-eng.php [Verified 19 December 2011]

Hurley J (2010) ‘Health economics.’ (McGraw-Hill-Ryerson: Toronto)

Kingston-Riechers J, Ospina M, Jonsson E, Childs P, McLeod L, Maxted J (2010) ‘Patient safety in primary care.’ (Canadian Patient Safety Institute and BC Patient Safety and Quality Council: Edmonton, AB) Available at http://www.patientsafetyinstitute.ca/english/research/commissionedresearch/primarycare/pages/default.aspx [Verified 19 December 2011]

Landry MD, Sibbald WJ (2002) Changing physician behavior: a review of patient safety in critical care medicine. Journal of Critical Care 17, 138–145.

National Patient Safety Institute (2011) 10 for 2010. Available at http://www.nrls.npsa.nhs.uk/resources/collections/10-for-2010/ [Verified 19 December 2011]

Ocloo JE (2010) Harmed patients gaining voice: challenging dominant perspectives in the construction of medical harm and patient safety. Social Science & Medicine 71, 510–516.
Harmed patients gaining voice: challenging dominant perspectives in the construction of medical harm and patient safety.Crossref | GoogleScholarGoogle Scholar |

Oftedal B, Karlsen B, Bru E (2010) Life values and self-regulation behaviours among adults with type 2 diabetes. Journal of Clinical Nursing 19, 2548–2556.

Palmieri PA, DeLucia PR, Peterson LT, Tammy E, Ott TE, Green A (2008) The anatomy and physiology of error in adverse health care events. In ‘Advances in health care management. Vol. 7’. (Eds GT Savage, EW Ford) pp. 33–68. Patient Safety and Health Care Management. (Emerald Publishing Group: Bingley, UK)

Pinto A, Burnett S, Benn J, Brett S, Parand A, Iskander S, Vincent C (2011) Improving reliability of clinical care practices for ventilated patients in the context of a patient safety improvement initiative. Journal of Evaluation in Clinical Practice 17, 180–187.

Reason JT (1990) ‘Human error.’ (Cambridge University Press: New York)

Reason J (2000) Human error: models and management. BMJ (Clinical Research Ed.) 320, 768–770.
Human error: models and management.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c7osFChtQ%3D%3D&md5=defe100736fb3c84e4b368705691367eCAS |

Runciman W, Hibbert P, Thomson R, Van Der Schaaf T, Sherman H, Lewalle P (2009) Towards an international classification for patient safety: key concepts and terms. International Journal for Quality in Health Care 21, 18–26.
Towards an international classification for patient safety: key concepts and terms.Crossref | GoogleScholarGoogle Scholar | 19147597PubMed |