Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study

Introduction: Most patient safety research has focused on specialist-care settings where there is an appreciation of the frequency and causes of medical errors, and the resulting burden of adverse events. There have, however, been few large-scale robust studies that have investigated the extent and...

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Main Authors: Bell, Brian, Campbell, Stephen, Carson-Stevens, Andrew, Prosser Evans, Huw, Cooper, Alison, Brindley, Christina, Rodgers, Sarah, Johnson, Christine, Edwards, Adrian, Armstrong, Sarah, Mehta, Rajnikant, Chuter, Antony, Donnelly, Alisa, Ashcroft, Darren M., Lymn, Joanne, Smith, Pam, Sheikh, Aziz, Boyd, Matthew, Avery, Anthony
Format: Article
Published: BMJ Publishing Group Ltd 2017
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Online Access:https://eprints.nottingham.ac.uk/39837/
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author Bell, Brian
Campbell, Stephen
Carson-Stevens, Andrew
Prosser Evans, Huw
Cooper, Alison
Brindley, Christina
Rodgers, Sarah
Johnson, Christine
Edwards, Adrian
Armstrong, Sarah
Mehta, Rajnikant
Chuter, Antony
Donnelly, Alisa
Ashcroft, Darren M.
Lymn, Joanne
Smith, Pam
Sheikh, Aziz
Boyd, Matthew
Avery, Anthony
author_facet Bell, Brian
Campbell, Stephen
Carson-Stevens, Andrew
Prosser Evans, Huw
Cooper, Alison
Brindley, Christina
Rodgers, Sarah
Johnson, Christine
Edwards, Adrian
Armstrong, Sarah
Mehta, Rajnikant
Chuter, Antony
Donnelly, Alisa
Ashcroft, Darren M.
Lymn, Joanne
Smith, Pam
Sheikh, Aziz
Boyd, Matthew
Avery, Anthony
author_sort Bell, Brian
building Nottingham Research Data Repository
collection Online Access
description Introduction: Most patient safety research has focused on specialist-care settings where there is an appreciation of the frequency and causes of medical errors, and the resulting burden of adverse events. There have, however, been few large-scale robust studies that have investigated the extent and severity of avoidable harm in primary care. To address this, we will conduct a 12-month retrospective cross-sectional study involving case note review of primary care patients. Methods and Analysis: We will conduct electronic searches of general practice (GP) clinical computer systems to identify patients with avoidable significant harm. Up to sixteen general practices from three areas of England (East Midlands, London and the North West) will be recruited based on practice size, to obtain a sample of around 100,000 patients. Our investigations will include an ‘enhanced sample’ of patients with the highest risk of avoidable significant harm. We will estimate the incidence of avoidable significant harm and express this as ‘per 100,000 patients per year’. Univariate and multivariate analysis will be conducted to identify the factors associated with avoidable significant harm. Ethics/Dissemination: The decision regarding participation by general practices in the study is entirely voluntary; the consent to participate may be withdrawn at any time. We will not seek individual patient consent for the retrospective case note review, but if patients respond to publicity about the project and say they do not wish their records to be included we will follow these instructions. We will produce a report for the Department of Health’s Policy Research Programme and several high-quality peer-reviewed publications in scientific journals. The study has been granted a favourable opinion by the East Midlands Nottingham 2 Research Ethics Committee (reference 15/EM/0411) and Confidentiality Advisory Group approval for access to medical records without consent under section 251 of the NHS Act 2006 (reference 15/CAG/0182).
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spelling nottingham-398372020-05-04T18:27:58Z https://eprints.nottingham.ac.uk/39837/ Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study Bell, Brian Campbell, Stephen Carson-Stevens, Andrew Prosser Evans, Huw Cooper, Alison Brindley, Christina Rodgers, Sarah Johnson, Christine Edwards, Adrian Armstrong, Sarah Mehta, Rajnikant Chuter, Antony Donnelly, Alisa Ashcroft, Darren M. Lymn, Joanne Smith, Pam Sheikh, Aziz Boyd, Matthew Avery, Anthony Introduction: Most patient safety research has focused on specialist-care settings where there is an appreciation of the frequency and causes of medical errors, and the resulting burden of adverse events. There have, however, been few large-scale robust studies that have investigated the extent and severity of avoidable harm in primary care. To address this, we will conduct a 12-month retrospective cross-sectional study involving case note review of primary care patients. Methods and Analysis: We will conduct electronic searches of general practice (GP) clinical computer systems to identify patients with avoidable significant harm. Up to sixteen general practices from three areas of England (East Midlands, London and the North West) will be recruited based on practice size, to obtain a sample of around 100,000 patients. Our investigations will include an ‘enhanced sample’ of patients with the highest risk of avoidable significant harm. We will estimate the incidence of avoidable significant harm and express this as ‘per 100,000 patients per year’. Univariate and multivariate analysis will be conducted to identify the factors associated with avoidable significant harm. Ethics/Dissemination: The decision regarding participation by general practices in the study is entirely voluntary; the consent to participate may be withdrawn at any time. We will not seek individual patient consent for the retrospective case note review, but if patients respond to publicity about the project and say they do not wish their records to be included we will follow these instructions. We will produce a report for the Department of Health’s Policy Research Programme and several high-quality peer-reviewed publications in scientific journals. The study has been granted a favourable opinion by the East Midlands Nottingham 2 Research Ethics Committee (reference 15/EM/0411) and Confidentiality Advisory Group approval for access to medical records without consent under section 251 of the NHS Act 2006 (reference 15/CAG/0182). BMJ Publishing Group Ltd 2017-02-01 Article PeerReviewed Bell, Brian, Campbell, Stephen, Carson-Stevens, Andrew, Prosser Evans, Huw, Cooper, Alison, Brindley, Christina, Rodgers, Sarah, Johnson, Christine, Edwards, Adrian, Armstrong, Sarah, Mehta, Rajnikant, Chuter, Antony, Donnelly, Alisa, Ashcroft, Darren M., Lymn, Joanne, Smith, Pam, Sheikh, Aziz, Boyd, Matthew and Avery, Anthony (2017) Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study. BMJ Open, 7 (2). e013786/1-e013786/8. ISSN 2044-6055 Patient safety Medical errors Avoidable harm Primary care http://bmjopen.bmj.com/content/7/2/e013786 doi:10.1136/bmjopen-2016-013786 doi:10.1136/bmjopen-2016-013786
spellingShingle Patient safety
Medical errors
Avoidable harm
Primary care
Bell, Brian
Campbell, Stephen
Carson-Stevens, Andrew
Prosser Evans, Huw
Cooper, Alison
Brindley, Christina
Rodgers, Sarah
Johnson, Christine
Edwards, Adrian
Armstrong, Sarah
Mehta, Rajnikant
Chuter, Antony
Donnelly, Alisa
Ashcroft, Darren M.
Lymn, Joanne
Smith, Pam
Sheikh, Aziz
Boyd, Matthew
Avery, Anthony
Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
title Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
title_full Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
title_fullStr Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
title_full_unstemmed Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
title_short Understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
title_sort understanding the epidemiology of avoidable significant harm in primary care: protocol for a retrospective cross-sectional study
topic Patient safety
Medical errors
Avoidable harm
Primary care
url https://eprints.nottingham.ac.uk/39837/
https://eprints.nottingham.ac.uk/39837/
https://eprints.nottingham.ac.uk/39837/