BMJ Open Quality最新文献

{"title":"Proactive advance care planning conversations in general practice: a quality improvement project.","authors":"Tabitha Winnifrith, Catherine Millington-Sanders, Emma Husbands, Jane Haros, Helen Ballinger","doi":"10.1136/bmjoq-2023-002679","DOIUrl":"10.1136/bmjoq-2023-002679","url":null,"abstract":"<p><p>Advance care planning (ACP) is a process of discussion, reflection and communication, enabling planning for future medical treatment. Despite evidence of benefits of ACP to patients, families and the healthcare system, many die without an opportunity for such conversations, particularly those living with progressive non-malignant conditions. The Royal College of General Practitioners and Marie Curie Daffodil Standards launched in 2020 provide primary care with a structure for improving end-of-life care, including delivery of ACP. Proactive identification of patients is integral to the approach.We report on a quality improvement project which aimed to assess the take-up rate and acceptability in general practice of a timely and personalised ACP conversation using a 'What matters to you' (WMTY) framework, and to ensure that different diagnostic and demographic groups were included.Patients without previous ACP and potentially in the last year of life were offered an ACP conversation; a survey sought feedback.81% accepted the offer and in most cases, future care guidance was documented using the recognised format in Gloucestershire for recording ACP conversations, the Recommended Summary for Emergency Care and Treatment (ReSPECT) plan. Clinician and patient satisfaction was high.We concluded that an ACP discussion using a 'WMTY' format was highly acceptable to most. With recognised enablers in place and known barriers minimised, valuable personalised conversations occurred. Reframing the conversation to focus on how someone wants to live, while including their priorities for death, could alter how such conversations are perceived by clinicians and the public. It could remove negative associations (such as linking these conversations with an imminent death), which may increase motivation for all to initiate discussions.ACP conversations are evidenced best practice and could become routine in general practice with adjustments to practice processes and clinician education; the Daffodil Standards facilitate continued quality improvement.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11256018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric of the Persian version of Quality of Life in Late-Stage Dementia (QUALID) in the elderly with Alzheimer's disease.","authors":"Zahra Amrollah Majdabadi Kohne, Abbas Ebadi, Mansoureh Ashghali-Farahani, Saleheh Tajali, Sahar Keyvanloo Shahrestanaki","doi":"10.1136/bmjoq-2023-002673","DOIUrl":"10.1136/bmjoq-2023-002673","url":null,"abstract":"<p><strong>Background: </strong>Improving the quality of life (QoL) is a significant healthcare priority, and it is an important health outcome for elderly individuals with Alzheimer's disease. Quality of Life in Late-Stage Dementia (QUALID) is a specific scale used to measure the QoL in elderly individuals with Alzheimer's. So far, limited quantitative research has been conducted on the psychometric properties of this scale.</p><p><strong>Aims: </strong>This study was conducted to translate the QUALID Scale into Persian and evaluate its psychometric properties among family and professional caregivers of elderly individuals with Alzheimer's disease in Tehran.</p><p><strong>Methods: </strong>A cross-sectional methodological study was conducted among family and professional caregivers of elderly individuals with Alzheimer's in Tehran, Iran in 2022. The questionnaire was translated into Persian using the forward-backward method. Face and content validity were assessed. Additionally, construct validity was examined using exploratory factor analysis (EFA) with Equamax rotation (n=210) and confirmatory factor analysis (CFA) (n=155). Cronbach's alpha and interclass correlation coefficient (ICC) were estimated to determine reliability.</p><p><strong>Results: </strong>A total of 365 caregivers with a mean age of 14.18±42.60 years participated in this study. In the face and content validity phase, all 11 items were retained. To determine the construct validity, two factors were extracted in the EFA phase, including behavioural signs of discomfort and behavioural signs of social interaction. The findings of the CFA also indicated that all goodness of fit indices supported the final model. The Cronbach's alpha was excellent for both factors (0.814), and the ICC was calculated as 0.98.</p><p><strong>Conclusion: </strong>Based on the findings of this study, it can be concluded that the Persian version of the QUALID Scale has sufficient validity and reliability for measuring the QoL in elderly Iranian individuals with Alzheimer's.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a customised set of evidence-based quality indicators for measuring workplace violence towards healthcare workers: a modified Delphi method.","authors":"Rickinder Sethi, Brendan Lyver, Jaswanth Gorla, Brendan Singh, Trevor Hanagan, Jennifer Haines, Marc Toppings, Christian Schulz-Quach","doi":"10.1136/bmjoq-2024-002855","DOIUrl":"10.1136/bmjoq-2024-002855","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence (WPV) is a complex global challenge in healthcare that can only be addressed through a quality improvement initiative composed of a complex intervention. However, multiple WPV-specific quality indicators are required to effectively monitor WPV and demonstrate an intervention's impact. This study aims to determine a set of quality indicators capable of effectively monitoring WPV in healthcare.</p><p><strong>Methods: </strong>This study used a modified Delphi process to systematically arrive at an expert consensus on relevant WPV quality indicators at a large, multisite academic health science centre in Toronto, Canada. The expert panel consisted of 30 stakeholders from the University Health Network (UHN) and its affiliates. Relevant literature-based quality indicators which had been identified through a rapid review were categorised according to the Donabedian model and presented to experts for two consecutive Delphi rounds.</p><p><strong>Results: </strong>87 distinct quality indicators identified through the rapid review process were assessed by our expert panel. The surveys received an average response rate of 83.1% in the first round and 96.7% in the second round. From the initial set of 87 quality indicators, our expert panel arrived at a consensus on 17 indicators including 7 structure, 6 process and 4 outcome indicators. A WPV dashboard was created to provide real-time data on each of these indicators.</p><p><strong>Conclusions: </strong>Using a modified Delphi methodology, a set of quality indicators validated by expert opinion was identified measuring WPV specific to UHN. The indicators identified in this study were found to be operationalisable at UHN and will provide longitudinal quality monitoring. They will inform data visualisation and dissemination tools which will impact organisational decision-making in real time.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Principles and elements of patient-centredness in mental health services: a thematic analysis of a systematic review of reviews.","authors":"Mohsen Khosravi, Ghazaleh Azar, Reyhane Izadi","doi":"10.1136/bmjoq-2023-002719","DOIUrl":"10.1136/bmjoq-2023-002719","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health disorders, particularly depression and anxiety, are widespread globally and necessitate effective solutions. The patient-centred approach has been identified as a viable and effective method for addressing these challenges. This paper synthesised the principles of patient-centred mental health services and provides a comprehensive review of the existing literature.</p><p><strong>Materials and methods: </strong>This is a qualitative content analysis study conducted in a systematic review framework in 2022. PubMed, Scopus, ProQuest and Cochrane databases were systematically searched, and by screening the titles, abstracts, and the texts of studies related to the purpose of the research, the data were extracted. Evaluation of the quality of the studies was done using the CASP checklist for qualitative studies. After selecting the final studies based on the entry and exit criteria, subsequently, a thematic analysis of findings was conducted on the data obtained from the systematic review.</p><p><strong>Results: </strong>The database search produced 6649 references. After screening, 11 studies met the inclusion criteria. The quality scores indicated the studies were of high level of quality with acceptable risk of bias. The thematic analysis identified six major principles of patient-centredness in mental health services: education, involvement and cooperation, access, effectiveness and safety, health and well-being, and ethics.</p><p><strong>Conclusions: </strong>Patient-centredness is a complex approach in mental health services. The principles and elements of patient-centredness foster positive patient outcomes, enhance healthcare quality and ensure compassionate and effective care. Upholding these principles is crucial for delivering patient-centred, ethical and effective mental health services. Furthermore, the study found that patient education can boost adherence and satisfaction, and decrease unnecessary hospitalisations. Patient involvement in decision-making is influenced by their age and the relationship with their psychologists. And, effective leadership and resource management can enhance clinical processes and patient-centredness in mental health services.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to improve system-level coproduction in the Cystic Fibrosis Learning Network","authors":"Breck Gamel, Dana Albon, Srujana Bandla, David W Davison, Jonathan Flath, Kathryn A Sabadosa, Michael Seid, Lindsay Silva, Thida Ong","doi":"10.1136/bmjoq-2024-002860","DOIUrl":"https://doi.org/10.1136/bmjoq-2024-002860","url":null,"abstract":"Background Coproduction is defined as patients and clinicians collaborating equally and reciprocally in healthcare and is a crucial concept for quality improvement (QI) of health services. Learning Health Networks (LHNs) provide insights to integrate coproduction with QI efforts from programmes from various health systems. Objective We describe interventions to develop and maintain patient and family partner (PFP) coproduction, measured by PFP-reported and programme-reported scales. We aim to increase percentage of programmes with PFPs reporting active QI work within their programme, while maintaining satisfaction in PFP-clinician relationships. Methods Conducted in the Cystic Fibrosis Learning Network (CFLN), an LHN comprising over 30 cystic fibrosis (CF) programmes, people with CF, caregivers and clinicians cocreated interventions in readiness awareness, inclusive PFP recruitment, onboarding process, partnership development and leadership opportunities. Interventions were adapted by CFLN programmes and summarised in a change package for existing programmes and the orientation of new ones. We collected monthly assessments for PFP and programme perceptions of coproduction and PFP self-rated competency of QI skills and satisfaction with programme QI efforts. We used control charts to analyse coproduction scales and run charts for PFP self-ratings. Results Between 2018 and 2022, the CFLN expanded to 34 programmes with 52% having ≥1 PFP reporting active QI participation. Clinicians from 76% of programmes reported PFPs were actively participating or leading QI efforts. PFPs reported increased QI skills competency (17%–32%) and consistently high satisfaction and feeling valued in their work. Conclusions Implementing system-level programmatic strategies to engage and sustain partnerships between clinicians and patients and families with CF improved perceptions of coproduction to conduct QI work. Key adaptable strategies for programmes included onboarding and QI training, supporting multiple PFPs simultaneously and developing financial recognition processes. Interventions may be applicable in other health conditions beyond CF seeking to foster the practice of coproduction. Data are available on reasonable request. Cystic Fibrosis Learning Network (CFLN) programme level data and aggregated participant rating data for coproduction scales are available by reasonable request to CFLN at cflearningnetwork@cff.org.","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141785726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised pilot study comparing a coach to SMARTPhone reminders to aid the management of heart failure (HF) patients: humans or machines.","authors":"Rahel Eynan, Robert Petrella, Cheryl Forchuk, Merrick Zwarenstein, James Calvin","doi":"10.1136/bmjoq-2024-002753","DOIUrl":"10.1136/bmjoq-2024-002753","url":null,"abstract":"<p><p>Ambulatory management of congestive heart failure (HF) continues to be a challenging clinical problem. Recent studies have focused on the role of HF clinics, nurse practitioners and disease management programmes to reduce HF readmissions. This pilot study is a pragmatic factorial study comparing a coach intervention, a SMARTPHONE REMINDER system intervention and BOTH interventions combined to Treatment as USUAL (TAU). We determined that both modalities were acceptable to patients prior to randomisation. Fifty-four patients were randomised to the four groups. The COACH group had no readmissions for HF 6 months after enrolment compared with 18% for the SMARTPHONE REMINDER Group, 8% for the BOTH intervention group and 13% for TAU. Medium-to-high medication adherence was maintained in all four groups although sodium consumption was lower at 3 months for the COACH and combined (BOTH) groups. This pilot study suggests a beneficial effect on rehospitalisation with the use of support measures including coaches and telephone reminders that needs confirmation in a larger trial.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11217996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed methods evaluation of a specialty-specific system to promote physician engagement in safety and quality reporting in a large academic health system","authors":"Anna Sophia Lessios, Stacie Vilendrer, Ashley Peterson, Cati Brown-Johnson, Samantha M.R. Kling, Darlene Veruttipong, Michelle Arteaga, Daniel Gessner, William John Gostic","doi":"10.1136/bmjoq-2024-002806","DOIUrl":"https://doi.org/10.1136/bmjoq-2024-002806","url":null,"abstract":"Background Incident reporting systems (IRS) can improve care quality and patient safety, yet their impact is limited by clinician engagement. Our objective was to assess barriers to reporting in a hospital-wide IRS and use data to inform ongoing improvement of a specialty-specific IRS embedded in the electronic health record targeting anaesthesiologists. Methods This quality improvement (QI) evaluation used mixed methods, including qualitative interviews, faculty surveys and user data from the specialty-specific IRS. We conducted 24 semi-structured interviews from January to May 2023 in a large academic health system in Northern California. Participants included adult and paediatric anaesthesiologists, operating room nurses, surgeons and QI operators, recruited through convenience and snowball sampling. We identified key themes and factors influencing engagement, which were classified using the Systems Engineering Initiative for Patient Safety framework. We surveyed hospital anaesthesiologists in January and May 2023, and characterised the quantity and type of reports submitted to the new system. Results Participants shared organisation and technology-related barriers to engagement in traditional system-wide IRSs, many of which the specialty-specific IRS addressed-specifically those related to technological access to the system. Barriers related to building psychological safety for those who report remain. Survey results showed that most barriers to reporting improved following the specialty-specific IRS launch, but limited time remained an ongoing barrier (25 respondents out of 44, 56.8%). A total of 964 reports with quality/safety concerns were submitted over the first 8 months of implementation; 47–76 unique anaesthesiologists engaged per month. The top safety quality categories of concern were equipment and technology (25.9%), clinical complications (25.3%) and communication and scheduling (19.9%). Conclusions These findings suggest that a specialty-specific IRS can facilitate increased physician engagement in quality and safety reporting and complement existing system-wide IRSs. Data are available upon reasonable request.","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141866838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontline nursing staff's perceptions of intravenous medication administration: the first step toward safer infusion processes-a qualitative study.","authors":"Masashi Uramatsu, Naoko Kimura, Takako Kojima, Yoshikazu Fujisawa, Tomoko Oto, Paul Barach","doi":"10.1136/bmjoq-2024-002809","DOIUrl":"10.1136/bmjoq-2024-002809","url":null,"abstract":"<p><strong>Objectives: </strong>Intravenous medication errors continue to significantly impact patient safety and outcomes. This study sought to clarify the complexity and risks of the intravenous administration process.</p><p><strong>Design: </strong>A qualitative focus group interview study.</p><p><strong>Setting: </strong>Focused interviews were conducted using process mapping with frontline nurses responsible for medication administration in September 2020.</p><p><strong>Participants: </strong>Front line experiened nurses from a Japanese tertiary teaching hospital.</p><p><strong>Primary and secondary outcome measures: </strong>The primary outcome measure was to identify the mental models frontline nurses used during intravenous medication administration, which influence their interactions with patients, and secondarily, to examine the medication process gaps between the mental models nurses perceive and the actual defined medication administration process.</p><p><strong>Results: </strong>We found gaps between the perceived clinical administration process and the real process challenges with an emphasis on the importance of verifying to see if the drug was ordered for the patient immediately before its administration.</p><p><strong>Conclusions: </strong>This novel and applied improvement approach can help nurses and managers better understand the process vulnerability of the infusion process and develop a deeper understanding of the administration steps useful for reliably improving the safety of intravenous medications.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing incidence of admission neonatal hypothermia in Gandhi Memorial Hospital, Addis Ababa, Ethiopia: quality improvement project.","authors":"Biniam Yohannes Wotango, Wubet Mihretu Workineh, Tariku Deressa Abdana, Hailegebriel Kidane, Aynekulu Aragaw, Bisrat Tamene Bekele","doi":"10.1136/bmjoq-2023-002656","DOIUrl":"10.1136/bmjoq-2023-002656","url":null,"abstract":"<p><strong>Background: </strong>WHO reported that neonatal hypothermia accounts for about 27% of newborn deaths worldwide. It is a serious concern in Ethiopia and other parts of sub-Saharan Africa; it poses a serious threat to global health, increasing morbidity and mortality. Hypothermic neonates are more likely to experience respiratory distress, infections and other issues that could result in longer hospital stays and delayed development. The objective of this quality improvement project was to minimise intensive medical treatments, maximise resource usage and enhance overall health outcomes for newborns at Gandhi Memorial Hospital by reducing neonatal hypothermia.</p><p><strong>Methods: </strong>Over 10 months (from 1 March 2021 to 30 January 2022), neonatal hypothermia incidence was assessed using Quality Supervision Mentoring Team and Health Management Information System data. Root cause analysis and literature review led to evidence-based interventions in a change bundle. After team training and neonatal intensive care unit (NICU) relocation, Plan-Do-Study-Act cycles tested the bundle. Close temperature monitoring and data collection occurred. Run charts evaluated intervention success against baseline data, informing conclusions about effectiveness.</p><p><strong>Result: </strong>The quality improvement project reduced neonatal hypothermia in NICU admissions from a baseline median of 80.6% to a performance median of 30%.</p><p><strong>Conclusion and recommendation: </strong>The quality improvement project at Gandhi Memorial Hospital effectively reduced neonatal hypothermia through interventions such as the temperature management bundle and NICU relocation, leading to improved patient care, fewer hypothermic neonates and enhanced body temperature management. Continuous monitoring, adherence to best practices, sharing success and outcome assessment are crucial for enhancing the project's effectiveness and sustaining positive impacts on neonatal hypothermia reduction and patient outcomes.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a survey to support assessment of safety learning systems.","authors":"Hassan Assem Mahmoud, Sunita Mulpuru, Kednapa Thavorn, Daniel McIsaac, Alan J Forster","doi":"10.1136/bmjoq-2023-002738","DOIUrl":"10.1136/bmjoq-2023-002738","url":null,"abstract":"<p><strong>Background: </strong>Patient safety learning systems play a critical role in supporting safety culture in healthcare organisations. A lack of explicit standards leads to inconsistent implementation across organisations, causing uncertainty about their roles and impact. Organisations can address inconsistent implementation by using a self-assessment tool based on agreed-on best practices. Therefore, we aimed to create a survey instrument to assess an organisation's approach to learning from safety events.</p><p><strong>Methods: </strong>The foundation for this work was a recent systematic review that defined features associated with the performance of a safety learning system. We organised features into themes and rephrased them into questions (items). Face validity was checked, which included independent pre-testing to ensure comprehensibility and parsimony. It also included clinical sensibility testing in which a representative sample of leaders in quality at a large teaching hospital (The Ottawa Hospital) answered two questions to judge each item for clarity and necessity. If more than 20% of respondents judged a question unclear or unnecessary, we modified or removed that question accordingly. Finally, we checked the internal consistency of the questionnaire using Cronbach's alpha.</p><p><strong>Results: </strong>We initially developed a 47-item questionnaire based on a prior systematic review. Pre-testing resulted in the modification of 15 of the questions, 2 were removed and 2 questions were added to ensure comprehensiveness and relevance. Face validity was assessed through yes/no responses, with over 80% of respondents confirming the clarity and 85% the necessity of each question, leading to the retention of all 47 questions. Data collected from the five-point responses (strongly disagree to strongly agree) for each question were used to assess the questionnaire's internal consistency. The Cronbach's alpha was 0.94, indicating a high internal consistency.</p><p><strong>Conclusion: </strong>This self-assessment questionnaire is evidence-based and on preliminary testing is deemed valid, comprehensible and reliable. Future work should assess the range of survey responses in a large sample of respondents from different hospitals.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}