BMC Health Services Research最新文献

{"title":"A systems based qualitative analysis exploring the potential to implement risk stratified bowel cancer screening in England.","authors":"Sowmiya Moorthie, Lily Taylor, Rebecca Dennison, Juliet Usher-Smith","doi":"10.1186/s12913-025-12381-w","DOIUrl":"10.1186/s12913-025-12381-w","url":null,"abstract":"<p><strong>Background: </strong>Improving bowel cancer screening programmes through the introduction of risk stratification has been discussed, but not widely implemented in many countries. This study aimed to gain an understanding of system and programmatic aspects that need to be addressed to enable a move towards implementation.</p><p><strong>Methods: </strong>The Engineering Better Care Framework was used to support exploration and thematic analysis of the views of stakeholders involved in delivery of bowel cancer screening in England. Semi-structured interviews (n = 11) were conducted to gain a better understanding of the problem, and to identify elements that would contribute to a well-designed programme and anticipate barriers to delivery.</p><p><strong>Results: </strong>There is enthusiasm for introducing risk stratification and it is considered to be beneficial to improving the current screening programme. A major barrier impacting implementation is a lack of consensus on the best approach for risk stratified screening. Many interviewees recognised this as a bottle-neck and were in favour of processes that would enable more joined up decision-making to enable balanced consideration of the differing, and often nuanced potential of different strategies for risk stratification. Several key considerations and design elements were identified: evidence demonstrating benefit of a particular strategy, feasibility of programme delivery (data availability, workforce capacity, public and patient acceptability, impact on equity), as well as changes to design of patient communication materials, the bowel cancer screening system, consent and follow-up services.</p><p><strong>Conclusions: </strong>System level issues and clarification of remaining uncertainties require resolution in order to move towards implementation. Moving this agenda forward requires consensus across different stakeholders in the first instance on the best use of risk. This will enable outlining key outstanding evidence gaps and establishing evidence thresholds for implementation. There are opportunities to design an optimal system based on harnessing existing infrastructure and learnings from other screening programmes.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"226"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a brief assessment of normative health and health-related social needs using the Simple Segmentation Tool.","authors":"David Matchar, Rakhi Vashishtha, Xu Jing, Nirmali Sivapragasam, Rita Sim, Jia Loon Chong","doi":"10.1186/s12913-025-12364-x","DOIUrl":"10.1186/s12913-025-12364-x","url":null,"abstract":"<p><strong>Objectives: </strong>Population segmentation provides a promising solution to address patients' complex needs to provide \"whole person\" care. The primary objective of this study is to create an expert-based algorithm based on combinations of medical and social characteristics derived from the Simple Segmentation Tool (SST), that are indicative of high value health and health-related social service (HASS) needs for an elderly population. The secondary objective was to examine the association between failing to meet the HASS needs 3-months post hospital discharge suggested by the algorithm and adverse outcomes over the ensuing year.</p><p><strong>Design & setting: </strong>Based on a parsimonious set of 10 patient characteristics identified in the SST, a representative expert panel was engaged using the Modified Appropriateness Methodology (MAM). A prospective study was then performed on patients admitted to the Singapore General Hospital, using HASS needs identified at discharge and met needs at 3 months post-discharge follow-up of services received, to assess whether unmet needs were associated with higher adverse outcomes in the year following discharge. The primary outcome of interest was time to all-cause mortality over 12-months post-discharge and was assessed with Cox regression analysis.</p><p><strong>Results: </strong>The MAM exercise resulted in 12 normatively defined high value services, using a combination of patients' medical and social characteristics based on the SST, as well as a list of means of providing those service needs. The all-cause mortality hazard ratio of having at least one unmet need versus having all needs met for individuals deemed to be chronically symptomatic at discharge was 1.949, (95% CI: 0.99 - 3.84, and p = 0.05), while for those who were either healthy or only had asymptomatic chronic conditions the all-cause mortality ratio of having at least one unmet need versus having all needs met was 0.28 (95% CI = 0.06-1.27 and p-value = 0.10). The hazard ratio for ED visits and hospital readmission were above one but did not reach level of 95% confidence level.</p><p><strong>Conclusion: </strong>The SST methodology provides a practical way to assess HASS needs that are predictive of mortality when needs are not met. It could serve as a screening tool to identify individuals who are likely to benefit from detailed care planning and follow-up.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"230"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unplanned re-attendance to emergency department of patients with systemic inflammatory response syndrome: a situational analysis.","authors":"Siwapon Srikeaw, Ketsarin Utriyaprasit, Wanlaya Thampanichawat, Siriorn Sindhu, Chukiat Viwatwongkasem, Thitipong Tankumpuan","doi":"10.1186/s12913-025-12371-y","DOIUrl":"10.1186/s12913-025-12371-y","url":null,"abstract":"<p><strong>Background: </strong>Unplanned re-attendance at the emergency department (ED) of patients with systemic inflammatory response syndrome (SIRS) remains unclear, and studies exploring health service factors related to unplanned re-attendance are limited. This study aimed to analyze the 30-day incidence of unplanned re-attendance in the ED following discharge and determine factors affecting unplanned re-attendance, including sociodemographic and clinical characteristics, agent, and the health service delivery system in patients with SIRS.</p><p><strong>Methods: </strong>This study employed a cross-sectional and prospective cohort study design. The sample comprised 900 patients and 14 ED supervisors. This study was conducted between February 1, 2021 and July 30, 2022 at 14 hospitals in Thailand. Data were collected using a standardized questionnaire and information from medical records.</p><p><strong>Results: </strong>The majority of the sample met two SIRS criteria (76.4%), of which respiratory rate (85.1%) and heart rate (74.5%) were the most common criteria. Most of the re-attendances were one-time (90.3%), and 30% developed sepsis and septic shock and required inpatient and critical care (45.8%). The unplanned re-attendance incidence was 16%, with an incidence rate of 6 persons per 1,000 persons/day. Middle-level hospitals had a higher re-attendance incidence (24%) than high-level (14.3%) and first-level (12.7%) hospitals. Factors affecting unplanned re-attendance to the ED within 30 days included comorbidities (hazard ratio [HR] = 5.0, 95% confidence interval [CI] = 3.056-8.413, p < 0.001), alcohol use (HR = 6.2, 95% CI = 3.555-10.854, p < 0.001), the model of care in the ED and discharge (HR = 11.1, 95% CI = 2.619-47.499, p < 0.001), and care in the ED and observed symptoms and discharge (HR = 13.8, 95% CI = 3.401-56.167, p < 0.001), which was the highest risk factor for unplanned re-attendance.</p><p><strong>Conclusions: </strong>The findings of this study indicate a high re-attendance occurrence among patients with SIRS. Both individual characteristics and health service delivery system efficiency play significant roles in influencing unplanned re-attendance. These factors can serve as valuable inputs for crafting policies aimed at enhancing the standard of care provided in EDs and guiding future research endeavors.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"222"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publisher Correction: The potential of a population register for addressing health inequities: an observational study using data linkage to improve breast cancer screening enrolment and participation in Indigenous Māori women in Aotearoa New Zealand.","authors":"Phyu Sin Aye, Karen Bartholomew, Michael Walsh, Kathy Pritchard, Maree Pierce, Jenny Richards, Erin Chambers, Aroha Haggie, Jesse Solomon, Gabrielle Lord, Tiffany Soloai, Lorraine Symons, Roimata Tipene, Rawiri McKree Jansen","doi":"10.1186/s12913-025-12376-7","DOIUrl":"10.1186/s12913-025-12376-7","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"225"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using ChatGPT for writing hospital inpatient discharge summaries - perspectives from an inpatient infectious diseases service.","authors":"Matthew Chung Yi Koh, Jinghao Nicholas Ngiam, Jolene Ee Ling Oon, Lionel Hon-Wai Lum, Nares Smitasin, Sophia Archuleta","doi":"10.1186/s12913-025-12373-w","DOIUrl":"10.1186/s12913-025-12373-w","url":null,"abstract":"<p><strong>Background: </strong>Hospital discharge summaries are important tools for communication between healthcare professionals. They convey events that occurred during hospitalisation, as well as the subsequent follow-up plans. Artificial intelligence models can be used to summarise information succinctly from large amounts of raw data input. We explored ChatGPT's ability to generate effective discharge summaries to assist junior doctors in writing these documents.</p><p><strong>Methods: </strong>We constructed three hypothetical scenarios of inpatient encounters, with three different outcomes: i) discharge home with follow-up with a general practitioner, ii) discharge to a stepdown facility for further physical rehabilitation, iii) transfer to a tertiary centre for more advanced care. ChatGPT was used to generate discharge summaries for these three scenarios. The quality of the responses provided were evaluated.</p><p><strong>Results: </strong>ChatGPT was able to provide an effective framework for discharge summaries. It processed large volumes of text, summarising pertinent issues and communicating follow-up plans clearly. It is a potentially useful tool for documentation for clinicians. However, pitfalls remain, where close reading is still required to ensure the veracity of the output provided.</p><p><strong>Conclusions: </strong>ChatGPT was able to synthesize patient information from a long prosaic format to provide a structured discharge summary. Future prospective study could evaluate if this framework provided by ChatGPT is helpful to aid junior doctors in learning about and writing discharge summaries more efficiently.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"221"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and strategies to reduce food waste in malaysian hospitals from the perspective of multidisciplinary professionals: a qualitative descriptive study.","authors":"Sangeetha Manimaran, Nurul Huda Razalli, Zahara Abdul Manaf, Suzana Shahar","doi":"10.1186/s12913-025-12365-w","DOIUrl":"10.1186/s12913-025-12365-w","url":null,"abstract":"<p><strong>Aim: </strong>This study explored the challenges and strategies related to reducing food waste in Malaysian hospitals.</p><p><strong>Method: </strong>The study employed a qualitative descriptive research design. Fifteen experienced participants were selected through purposive sampling to take part in three focus group discussions. Each focus group consisted of 4 to 6 participants, with the mean age of the participants being (mean ± SD = 47.5 ± 5.90). The majority were females (n = 12, 80%) and males (n = 3, 20%) involved in hospital food service, including catering officers, assistant catering officers, dietitians, nurse managers, and researchers or academicians who participated in three focus group discussions.</p><p><strong>Results: </strong>A total of five major challenges in hospital food service including a) shortcomings in hospital foodservice management systems and policies; b) patients' meal experiences and dietary practices during hospital stay; c) insufficient training, awareness, and resources in food waste management; d) insufficient menu variety and lack of patient choice across different ward classes; and e) lack of staff engagement and accountability in addressing food waste and enhancing patient meal care. Subsequently, a total of six major actionable intervention strategies for food waste reduction were identified, namely: a) optimising meal ordering systems and implementing centralised plating; b) enhancing communication in food waste management; c) enforcing appropriate portion control, improving food quality and presentation; d) strategic menu planning; e) staff training programs aimed at reducing waste; and f) improving work performance.</p><p><strong>Conclusion: </strong>To reduce food waste in Malaysian hospital foodservices, it is crucial to address challenges through targeted strategies, develop tools, and provide training for foodservice staff and nurses. The assessment data will guide tailored interventions to promote sustainability, improve food service efficiency, and enhance patient satisfaction.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"224"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assistive technologies in healthcare: utilization and healthcare workers perceptions in Germany.","authors":"Domenic Sommer, Eva Lermer, Florian Wahl, Luis I Lopera G","doi":"10.1186/s12913-024-12162-x","DOIUrl":"10.1186/s12913-024-12162-x","url":null,"abstract":"<p><strong>Background: </strong>According to the WHO, assistive technology (AT) is defined as the superset of technologies that improve or maintain the functioning of different senses, mobility, self-care, well-being, and inclusion of patients. ATs also include technologies for healthcare workers (HCWs) to reduce workloads and improve efficiency and patient care outcomes. Software ATs for HCWs include communication software, artificial intelligence (AI), text editors, planning tools, decision support systems, and health records. Hardware ATs for HCWs can range from communication devices, sensors, and specialized medical equipment to robots.</p><p><strong>Aims: </strong>With this indicative study, we explore HCW utilization, perceptions, and adoption barriers of ATs. We emphasize ATs role in enhancing HCWs' efficiency and effectiveness in healthcare delivery.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted through August 2024 with HCWs in Bavaria via a network recruiting approach. We used convenience sampling but ensured that only HCWs were part of our study population. Our survey included (i) usage, (ii) usefulness, and (iii) perceptions regarding ATs. The survey comprised 11 close-ended and three open-ended questions, including story stems evaluated by a deductive qualitative template analysis. Our mixed-method evaluation also employed descriptive and bivariate statistics.</p><p><strong>Results: </strong>Three hundred seventy-one HCWs (♂63.9 %, ♀36.1 %) participated in our survey, primarily 133 administrators, 116 nurses, and 34 doctors. More than half of the study participants (58.6 %) reported having advanced technical skills. Regarding usage, communication platforms (82.2 %) and communication devices (86 %) were the most commonly used ATs. Advanced ATs such as body-worn sensors, medical devices with interfaces, identification devices, and robots were underutilized in our sample. ATs were reported to be helpful in all job roles but need improvements in capacity and integration. Key barriers to adoption included outdated infrastructure, interoperability, and a lack of training.</p><p><strong>Conclusion: </strong>Our study suggests that HCWs may want to incorporate ATs into their workflows as they see how, in theory, these technologies would improve HCW's efficiency, resulting in better patient care. However, to realize this potential, efforts in ATs integration and accessibility are essential. Given this study's modest sample size and generalizability limitations, further research is needed to explore the adoption, implementation, and impact of ATs in healthcare.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"223"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholders' experiences, perceptions and satisfaction with an electronic appointment system: a qualitative content analysis.","authors":"Faezeh Ostadmohammadi, Ehsan Nabovati, Fatemeh Rangraze Jeddi, Leila Shokrizadeh Arani","doi":"10.1186/s12913-025-12289-5","DOIUrl":"10.1186/s12913-025-12289-5","url":null,"abstract":"<p><strong>Background: </strong>Online appointment scheduling systems have been designed and implemented to address barriers and problems related to in-person appointment scheduling; however, these systems also face challenges and issues that require continuous evaluation and resolution. This research aimed to investigate the experiences, perceptions and satisfaction of stakeholders with an electronic appointment system and identify its problems.</p><p><strong>Methods: </strong>This was a qualitative study conducted at a specialty Clinic in Iran during 2022-2023. A systematic purposive sampling method was used to select the participants. The participants included 10 administrative and executive users working at the Specialty Clinic, 8 physicians working at the clinic and 18 patients and visitors to the clinic. Data was collected through semi-structured face-to-face interviews. The interviews were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>The findings derived from the semi-structured interview data revealed that the problems with the appointment system fell into two main themes: \"Problems Related to Planning and Management of the Electronic Appointment System\" and \"Non-managerial Problems of the Electronic Appointment System\". The problems related to planning and management were divided into three categories: national-level system management, university-level system management and clinic-level system management. The non-managerial problems were classified into two groups: functional problems and non-functional problems.</p><p><strong>Conclusions: </strong>The results of this study showed that the electronic appointment system, despite facilitating appointment processes, can be influenced by various factors and lead to stakeholder dissatisfaction. Planning, management and policymaking have a significant impact on the appointment process of healthcare centers and attention to the problems arising from it is of particular importance. Moreover, if the functional and non-functional requirements of appointment systems are unclear, the system will face many challenges.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"220"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a co-design approach to develop a Preventative Online Mental Health Program for Youth (POMHPY): a quality improvement project.","authors":"Elnaz Moghimi, Kimberly Belfry, Sarah Farr, Shavon Stafford, Arina Bogdan, Megan Brush, Christopher Canning, Soyeon Kim","doi":"10.1186/s12913-024-12101-w","DOIUrl":"10.1186/s12913-024-12101-w","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, youth in Ontario, Canada experienced a steep rise in mental health concerns. Preventative intervention programs can address the psychological impact of the pandemic on youth and build resiliency. Co-design approaches to developing such programs actively involve young people, resulting in solutions tailored to their unique needs. The current paper details the co-design approach to creating a Preventative Online Mental Health Program for Youth (POMHPY)-a virtually delivered program designed for Ontario youth ages 12 to 25 that promotes mental, physical, and social wellbeing.</p><p><strong>Methods: </strong>The Participatory Action Research (PAR) framework guided the development of the initiative. Literature reviews were conducted to identify existing evidence-based programs targeting youth. Youth perspectives were primarily gathered via the Youth Advisory Group, comprising a Youth Resilience Coordinator and a Youth Engagement Lead, who contributed to a literature review, surveys, focus groups, and program assets. Community insights were gathered through Community Reference Group (CRG) meetings, which engaged participants from local and provincial organizations, as well as individuals either directly representing or affiliated at arm's length with youth.</p><p><strong>Results: </strong>A review of the current literature highlighted the importance of regular physical activity, social connectedness, good sleep hygiene, and healthy family relationships to emotional wellbeing. Survey findings informed program session length, duration, delivery, and activities. Focus groups expanded on the survey findings and provided an in-depth understanding of youth preferences for program delivery. CRG meetings captured community insights on program refinements to better meet the needs of youth. As such, the development of POMHPY was a collaborative effort among researchers, youth, and community partners.</p><p><strong>Conclusions: </strong>The findings highlight the value of co-design and PAR-informed approaches in developing youth-targeted online wellbeing programs, providing actionable insights for iterative improvements and future pilot testing. The resulting 6-week program, led by youth facilitators, will focus on teaching mental, social, and physical wellness strategies and skills through various evidence-based, interactive activities.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"219"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient safety culture through the lenses of surgical patients: a qualitative study.","authors":"Magnhild Vikan, Arvid S Haugen, Berit T Valeberg, Ann K Bjørnnes, Vigdis K S Husby, Ellen Ct Deilkås, Stein O Danielsen","doi":"10.1186/s12913-025-12366-9","DOIUrl":"10.1186/s12913-025-12366-9","url":null,"abstract":"<p><strong>Background: </strong>Patient engagement and learning from patients' experiences may increase patient safety and reduce the occurrence of adverse events. Most adverse events are related to surgery, and patient outcomes are positively associated with patient safety culture. This study aimed to explore former surgical patients' perspectives and experiences of adverse events and patient safety culture during their surgical pathway and identify themes relevant to adverse event causes and quality improvement projects.</p><p><strong>Methods: </strong>The design of this qualitative study was explorative, utilizing an abductive approach. We purposefully recruited former surgical patients from Norwegian user organizations based on group characteristics sampling. The participants were 57% men and 43% women, aged 35 to 64 years. We conducted 14 individual semi-structured interviews between 18/01/24 and 07/03/24 using Zoom's video audio software, with an average duration of 65 min. We analyzed the data using Braun and Clarke's method for reflexive thematic analysis, and generated themes by examining patterns of meaning throughout the dataset.</p><p><strong>Results: </strong>Data analysis generated three themes concerning the former surgical patients' perspectives of patient safety culture and adverse events: (1) \"Personalized care and predictable pathways increase patients' sense of safety\"; (2) \"Surgical patients' involvement: Aspire to be a resource - Not a threat\"; and (3) \"Time to cultivate a culture that fosters improvements and reconciliation.\"</p><p><strong>Conclusions: </strong>This study provided insight into patients' perspectives on adverse events and patient safety culture in the surgical context. The patients underscored the value of predictable plans in caregiving, tailored information, personalized care, and dialogue on equal terms. They considered the demand for efficiency, professional hierarchy, status, prestige, and authority to be barriers to patient engagement and safety. Interventions to improve a culture of openness, psychological safety, and organizational learning in the surgical context could increase the safety of patients and healthcare professionals. Finally, acknowledgment of adverse events, information, and follow-up were essential for patients and next of kin to move on after an adverse event.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"215"},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}