Dataset Information

Never events in general practice: a focus group study exploring the views of English and Scottish general practitioners of 'never events'.

ABSTRACT:

Objectives

To examine general practitioner (GP) understanding of the never event (NE) concept in general practice, and to identify potential enablers and barriers to implementation in UK general practice.

Design

Qualitative study using focus groups. The data were analysed thematically and were informed by the normalisation process theory.

Setting

General practice in Northwest England and Southwest Scotland.

Participants

25 GPs took part in five focus groups. 13 GPs were female and 12 male with an age range of 28-60.

Results

The NE approach of avoiding serious preventable adverse outcomes from healthcare fitted with participants expectations of the delivery of care but the implementation of strategies to prevent the specific NE was considered complex and variable. The main themes identified participants' understandings and perceived limitations of the NE concept; the embedded layers of responsibility to implement NE within practices and the work required for implementation within general practices. Participants' accounts highlighted the differential nature of work in general practice and that the implementation of initiatives to address specific NE should be situated within a learning and systems approach to implementation. Some NEs were considered more relevant and amenable to simple solutions than others which could influence implementation.

Conclusions

The NE concept was considered overall an important approach to help address key primary care patient safety issues. The utility of individual NEs may vary depending on the complexity of the initiatives that would be needed to manage related risks to as low as reasonably practicable.

SUBMITTER: Morris RL

PROVIDER: S-EPMC6661597 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Never events in general practice: a focus group study exploring the views of English and Scottish general practitioners of 'never events'.

Morris Rebecca L RL Cheraghi-Sohi Sudeh S Bowie Paul P Esmail Aneez A de Wet Carl C Campbell Stephen M SM

BMJ open 20190723 7

<h4>Objectives</h4>To examine general practitioner (GP) understanding of the never event (NE) concept in general practice, and to identify potential enablers and barriers to implementation in UK general practice.<h4>Design</h4>Qualitative study using focus groups. The data were analysed thematically and were informed by the normalisation process theory.<h4>Setting</h4>General practice in Northwest England and Southwest Scotland.<h4>Participants</h4>25 GPs took part in five focus groups. 13 GPs w ...[more]

PMID: 31340968

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Project description:BackgroundWe report on a multidisciplinary focus group project related to the appropriate care of chiropractic patients who present with chest pain. The prevalence and clinical management, both diagnosis and treatment, of musculoskeletal chest pain in ambulatory medical settings, was explored as the second dimension of the focus group project reported here.MethodsThis project collected observational data from a multidisciplinary focus group composed of both chiropractic and medical professionals. The goals of the focus group were to explore the attitudes and experiences of medical and chiropractic clinicians regarding their patients with chest pain who receive care from both medical and chiropractic providers, to identify important clinical or research questions that may inform the development of 'best practices' for coordinating or managing care of chest pain patients between medical and chiropractic providers, to identify important clinical or research questions regarding the diagnosis and treatment of chest pain of musculoskeletal origin, to explore various methods that might be used to answer those questions, and to discuss the feasibility of conducting or coordinating a multidisciplinary research effort along this line of inquiry. The convenience-sample of five focus group participants included two chiropractors, two medical cardiologists, and one dual-degreed chiropractor/medical physician. The focus group was audiotaped and transcripts were prepared of the focus group interaction. Content analysis of the focus group transcripts were performed to identify key themes and concepts, using categories of narratives.ResultsSix key themes emerged from the analysis of the focus group interaction, including issues surrounding (1) Diagnosis; (2) Treatment and prognosis; (3) Chest pain as a chronic, multifactorial, or comorbid condition; (4) Inter-professional coordination of care; (5) Best practices and standardization of care; and (6) Training and education.ConclusionThis study carries implications for chiropractic clinical training relative to enhancing diagnostic competencies in chest pain, as well as the need to ascertain and improve those skills, competencies, and standards for referrals and sharing of clinical information that may improve cross-disciplinary coordination of care for chest pain patients.

Dataset Information

Never events in general practice: a focus group study exploring the views of English and Scottish general practitioners of 'never events'.

Objectives

Design

Setting

Participants

Results

Conclusions

Publications

Never events in general practice: a focus group study exploring the views of English and Scottish general practitioners of 'never events'.

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