Junior doctors' reflections on patient safety
AimTo determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care.MethodsA cross-sectional retrospective review of every ‘reflective practice’ portfolio entry made by all FY1 do...
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Published in | Postgraduate medical journal Vol. 88; no. 1037; pp. 125 - 129 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
London
The Fellowship of Postgraduate Medicine
01.03.2012
BMJ Publishing Group Oxford University Press |
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Abstract | AimTo determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care.MethodsA cross-sectional retrospective review of every ‘reflective practice’ portfolio entry made by all FY1 doctors within an Acute Teaching Hospital Trust was conducted in February 2010. Entries were reviewed by two independent blinded researchers to determine whether they related to a PSI that is, any unintended or unexpected incident that could have or did lead to patient harm. For all entries rated positive by both reviewers, a content analysis approach was used to code PSI into incident type, contributing factors and patient outcome according to validated frameworks developed by the National Patient Safety Agency.Results139 reflective practice entries were completed by 30 trainees (15 men, 15 women, mean age 24 years). Of the 139 entries, 49% reflected on a PSI. Of these, 22% were due to errors in clinical assessment; 22% were due to delayed access to care; 18% were due to infrastructure/staffing deficiencies; and 16% were due to medication errors. The most common contributing factors were team/social factors (23%), patient factors (22%), communication and task factors (both 17%). The majority of PSIs led to no harm. Six entries described PSIs resulting in patient death, the majority of which were attributable to diagnostic errors.ConclusionsFY1 doctors commonly reflect on PSIs within their professional portfolios. Such critical reflection can encourage learning but may also promote patient safety and the quality of healthcare across all medical specialties. |
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AbstractList | Abstract
Aim
To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care.
Methods
A cross-sectional retrospective review of every ‘reflective practice’ portfolio entry made by all FY1 doctors within an Acute Teaching Hospital Trust was conducted in February 2010. Entries were reviewed by two independent blinded researchers to determine whether they related to a PSI that is, any unintended or unexpected incident that could have or did lead to patient harm. For all entries rated positive by both reviewers, a content analysis approach was used to code PSI into incident type, contributing factors and patient outcome according to validated frameworks developed by the National Patient Safety Agency.
Results
139 reflective practice entries were completed by 30 trainees (15 men, 15 women, mean age 24 years). Of the 139 entries, 49% reflected on a PSI. Of these, 22% were due to errors in clinical assessment; 22% were due to delayed access to care; 18% were due to infrastructure/staffing deficiencies; and 16% were due to medication errors. The most common contributing factors were team/social factors (23%), patient factors (22%), communication and task factors (both 17%). The majority of PSIs led to no harm. Six entries described PSIs resulting in patient death, the majority of which were attributable to diagnostic errors.
Conclusions
FY1 doctors commonly reflect on PSIs within their professional portfolios. Such critical reflection can encourage learning but may also promote patient safety and the quality of healthcare across all medical specialties. AIMTo determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care.METHODSA cross-sectional retrospective review of every 'reflective practice' portfolio entry made by all FY1 doctors within an Acute Teaching Hospital Trust was conducted in February 2010. Entries were reviewed by two independent blinded researchers to determine whether they related to a PSI that is, any unintended or unexpected incident that could have or did lead to patient harm. For all entries rated positive by both reviewers, a content analysis approach was used to code PSI into incident type, contributing factors and patient outcome according to validated frameworks developed by the National Patient Safety Agency.RESULTS139 reflective practice entries were completed by 30 trainees (15 men, 15 women, mean age 24 years). Of the 139 entries, 49% reflected on a PSI. Of these, 22% were due to errors in clinical assessment; 22% were due to delayed access to care; 18% were due to infrastructure/staffing deficiencies; and 16% were due to medication errors. The most common contributing factors were team/social factors (23%), patient factors (22%), communication and task factors (both 17%). The majority of PSIs led to no harm. Six entries described PSIs resulting in patient death, the majority of which were attributable to diagnostic errors.CONCLUSIONSFY1 doctors commonly reflect on PSIs within their professional portfolios. Such critical reflection can encourage learning but may also promote patient safety and the quality of healthcare across all medical specialties. Aim To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care. Methods A cross-sectional retrospective review of every 'reflective practice' portfolio entry made by all FY1 doctors within an Acute Teaching Hospital Trust was conducted in February 2010. Entries were reviewed by two independent blinded researchers to determine whether they related to a PSI that is, any unintended or unexpected incident that could have or did lead to patient harm. For all entries rated positive by both reviewers, a content analysis approach was used to code PSI into incident type, contributing factors and patient outcome according to validated frameworks developed by the National Patient Safety Agency. Results 139 reflective practice entries were completed by 30 trainees (15 men, 15 women, mean age 24 years). Of the 139 entries, 49% reflected on a PSI. Of these, 22% were due to errors in clinical assessment; 22% were due to delayed access to care; 18% were due to infrastructure/staffing deficiencies; and 16% were due to medication errors. The most common contributing factors were team/social factors (23%), patient factors (22%), communication and task factors (both 17%). The majority of PSIs led to no harm. Six entries described PSIs resulting in patient death, the majority of which were attributable to diagnostic errors. Conclusions FY1 doctors commonly reflect on PSIs within their professional portfolios. Such critical reflection can encourage learning but may also promote patient safety and the quality of healthcare across all medical specialties. To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care. A cross-sectional retrospective review of every 'reflective practice' portfolio entry made by all FY1 doctors within an Acute Teaching Hospital Trust was conducted in February 2010. Entries were reviewed by two independent blinded researchers to determine whether they related to a PSI that is, any unintended or unexpected incident that could have or did lead to patient harm. For all entries rated positive by both reviewers, a content analysis approach was used to code PSI into incident type, contributing factors and patient outcome according to validated frameworks developed by the National Patient Safety Agency. 139 reflective practice entries were completed by 30 trainees (15 men, 15 women, mean age 24 years). Of the 139 entries, 49% reflected on a PSI. Of these, 22% were due to errors in clinical assessment; 22% were due to delayed access to care; 18% were due to infrastructure/staffing deficiencies; and 16% were due to medication errors. The most common contributing factors were team/social factors (23%), patient factors (22%), communication and task factors (both 17%). The majority of PSIs led to no harm. Six entries described PSIs resulting in patient death, the majority of which were attributable to diagnostic errors. FY1 doctors commonly reflect on PSIs within their professional portfolios. Such critical reflection can encourage learning but may also promote patient safety and the quality of healthcare across all medical specialties. |
Author | Neale, Graham Ahmed, Maria Arora, Sonal Sevdalis, Nick Carley, Simon |
Author_xml | – sequence: 1 givenname: Maria surname: Ahmed fullname: Ahmed, Maria email: maria.ahmed@imperial.ac.uk organization: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, UK – sequence: 2 givenname: Sonal surname: Arora fullname: Arora, Sonal email: maria.ahmed@imperial.ac.uk organization: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, UK – sequence: 3 givenname: Simon surname: Carley fullname: Carley, Simon email: maria.ahmed@imperial.ac.uk organization: Postgraduate Medical Education Department, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK – sequence: 4 givenname: Nick surname: Sevdalis fullname: Sevdalis, Nick email: maria.ahmed@imperial.ac.uk organization: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, UK – sequence: 5 givenname: Graham surname: Neale fullname: Neale, Graham email: maria.ahmed@imperial.ac.uk organization: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, UK |
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Cites_doi | http://www.bmj.com/campaigns/juniordoctors/ 10.1111/j.1365-2753.2009.01328.x 10.1136/pgmj.2011.117366 10.3109/01421590903188737 10.1002/9781444323856 10.1186/1472-6920-7-5 10.1080/01421590902889897 10.1001/jama.1991.03460160067031 10.1016/0277-9536(84)90280-6 10.1136/bmj.295.6597.533 10.1136/bmj.320.7237.726 10.1080/01421590902883056 10.1097/ACM.0b013e3181f54eed 10.1136/bmj.b1046 10.1080/01421590903050374 |
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Snippet | AimTo determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such... Aim To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such... To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such... Abstract Aim To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value... AIMTo determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such... |
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SubjectTerms | Biological and medical sciences Clinical Competence - standards Clinical medicine Content analysis Cross-Sectional Studies Female General aspects Health education Humans Male Medical sciences Medical Staff, Hospital - psychology Medication Errors Patient safety Patient Safety - standards Physicians Portfolios Professional development Quality of Health Care Reflective teaching Retrospective Studies Review Literature as Topic Young Adult |
Title | Junior doctors' reflections on patient safety |
URI | http://dx.doi.org/10.1136/postgradmedj-2011-130301 https://api.istex.fr/ark:/67375/NVC-3VWH3JDT-9/fulltext.pdf https://www.ncbi.nlm.nih.gov/pubmed/22247317 https://www.proquest.com/docview/1781652244 https://search.proquest.com/docview/922501278 |
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