Perspectives of healthcare professionals in Qatar on causes of medication errors

A mixed methods study of safety culture

Derek Stewart (Corresponding Author), Binny Thomas, Katie MacLure, Abdulrouf Pallivalapila, Wessam El Kassem, Ahmed Awaisu, James S McLay, Kerry Wilbur, Kyle Wilby, Cristin Ryan, Andrea Dijkstra, Rajvir Singh, Moza Al Hail

Research output: Contribution to journalArticle

2 Citations (Scopus)
5 Downloads (Pure)

Abstract

BACKGROUND: There is a lack of robust, rigorous mixed methods studies of patient safety culture generally and notably those which incorporate behavioural theories of change. The study aimed to quantify and explain key aspects of patient safety culture which were of most concern to healthcare professionals in Qatar.

METHODS: A sequential explanatory mixed methods design of a cross-sectional survey followed by focus groups in Hamad Medical Corporation, Qatar. All doctors, nurses and pharmacists were invited to complete the Hospital Survey on Patient Safety Culture (HSOPS). Respondents expressing interest in focus group participation were sampled purposively, and discussions based on survey findings using the Theoretical Domains Framework (TDF) to explain behavioural determinants.

RESULTS: One thousand, six hundred and four questionnaires were received (67.9% nurses, 13.3% doctors, 12.9% pharmacists). HSOPS composites with the lowest levels of positive responses were non-punitive response to errors (24.0% positive) and staffing (36.2%). Specific TDF determinants potentially associated with these composites were social/professional role and identity, emotions, and environmental context and resources. Thematic analysis identified issues of doctors relying on pharmacists to correct their errors and being reluctant to alter the prescribing of fellow doctors. There was a lack of recognition of nurses' roles and frequent policy non-adherence. Stress, workload and lack of staff at key times were perceived to be major contributors to errors.

CONCLUSIONS: This study has quantified areas of concern relating to patient safety culture in Qatar and suggested important behavioural determinants. Rather than focusing on changing behaviour at the individual practitioner level, action may be required at the organisational strategic level to review policies, structures (including resource allocation and distribution) and processes which aim to promote patient safety culture.

Original languageEnglish
Article numbere0204801
JournalPloS ONE
Volume13
Issue number9
DOIs
Publication statusPublished - 28 Sep 2018

Fingerprint

Qatar
Safety Management
Medication Errors
health care workers
Patient Safety
drug therapy
Delivery of Health Care
physicians
nurses
Pharmacists
focus groups
Focus Groups
methodology
Nurses
Professional Role
Resource Allocation
Nurse's Role
corporations
Composite materials
resource allocation

Cite this

Stewart, D., Thomas, B., MacLure, K., Pallivalapila, A., El Kassem, W., Awaisu, A., ... Al Hail, M. (2018). Perspectives of healthcare professionals in Qatar on causes of medication errors: A mixed methods study of safety culture. PloS ONE, 13(9), [e0204801]. https://doi.org/10.1371/journal.pone.0204801

Perspectives of healthcare professionals in Qatar on causes of medication errors : A mixed methods study of safety culture. / Stewart, Derek (Corresponding Author); Thomas, Binny; MacLure, Katie; Pallivalapila, Abdulrouf; El Kassem, Wessam; Awaisu, Ahmed; McLay, James S; Wilbur, Kerry; Wilby, Kyle; Ryan, Cristin; Dijkstra, Andrea; Singh, Rajvir; Al Hail, Moza.

In: PloS ONE, Vol. 13, No. 9, e0204801, 28.09.2018.

Research output: Contribution to journalArticle

Stewart, D, Thomas, B, MacLure, K, Pallivalapila, A, El Kassem, W, Awaisu, A, McLay, JS, Wilbur, K, Wilby, K, Ryan, C, Dijkstra, A, Singh, R & Al Hail, M 2018, 'Perspectives of healthcare professionals in Qatar on causes of medication errors: A mixed methods study of safety culture', PloS ONE, vol. 13, no. 9, e0204801. https://doi.org/10.1371/journal.pone.0204801
Stewart, Derek ; Thomas, Binny ; MacLure, Katie ; Pallivalapila, Abdulrouf ; El Kassem, Wessam ; Awaisu, Ahmed ; McLay, James S ; Wilbur, Kerry ; Wilby, Kyle ; Ryan, Cristin ; Dijkstra, Andrea ; Singh, Rajvir ; Al Hail, Moza. / Perspectives of healthcare professionals in Qatar on causes of medication errors : A mixed methods study of safety culture. In: PloS ONE. 2018 ; Vol. 13, No. 9.
@article{395a73218209418c82083a81a688e9aa,
title = "Perspectives of healthcare professionals in Qatar on causes of medication errors: A mixed methods study of safety culture",
abstract = "BACKGROUND: There is a lack of robust, rigorous mixed methods studies of patient safety culture generally and notably those which incorporate behavioural theories of change. The study aimed to quantify and explain key aspects of patient safety culture which were of most concern to healthcare professionals in Qatar.METHODS: A sequential explanatory mixed methods design of a cross-sectional survey followed by focus groups in Hamad Medical Corporation, Qatar. All doctors, nurses and pharmacists were invited to complete the Hospital Survey on Patient Safety Culture (HSOPS). Respondents expressing interest in focus group participation were sampled purposively, and discussions based on survey findings using the Theoretical Domains Framework (TDF) to explain behavioural determinants.RESULTS: One thousand, six hundred and four questionnaires were received (67.9{\%} nurses, 13.3{\%} doctors, 12.9{\%} pharmacists). HSOPS composites with the lowest levels of positive responses were non-punitive response to errors (24.0{\%} positive) and staffing (36.2{\%}). Specific TDF determinants potentially associated with these composites were social/professional role and identity, emotions, and environmental context and resources. Thematic analysis identified issues of doctors relying on pharmacists to correct their errors and being reluctant to alter the prescribing of fellow doctors. There was a lack of recognition of nurses' roles and frequent policy non-adherence. Stress, workload and lack of staff at key times were perceived to be major contributors to errors.CONCLUSIONS: This study has quantified areas of concern relating to patient safety culture in Qatar and suggested important behavioural determinants. Rather than focusing on changing behaviour at the individual practitioner level, action may be required at the organisational strategic level to review policies, structures (including resource allocation and distribution) and processes which aim to promote patient safety culture.",
author = "Derek Stewart and Binny Thomas and Katie MacLure and Abdulrouf Pallivalapila and {El Kassem}, Wessam and Ahmed Awaisu and McLay, {James S} and Kerry Wilbur and Kyle Wilby and Cristin Ryan and Andrea Dijkstra and Rajvir Singh and {Al Hail}, Moza",
note = "This publication was made possible by NPRP grant NPRP 7-388-3-095 from Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the authors.",
year = "2018",
month = "9",
day = "28",
doi = "10.1371/journal.pone.0204801",
language = "English",
volume = "13",
journal = "PloS ONE",
issn = "1932-6203",
publisher = "PUBLIC LIBRARY SCIENCE",
number = "9",

}

TY - JOUR

T1 - Perspectives of healthcare professionals in Qatar on causes of medication errors

T2 - A mixed methods study of safety culture

AU - Stewart, Derek

AU - Thomas, Binny

AU - MacLure, Katie

AU - Pallivalapila, Abdulrouf

AU - El Kassem, Wessam

AU - Awaisu, Ahmed

AU - McLay, James S

AU - Wilbur, Kerry

AU - Wilby, Kyle

AU - Ryan, Cristin

AU - Dijkstra, Andrea

AU - Singh, Rajvir

AU - Al Hail, Moza

N1 - This publication was made possible by NPRP grant NPRP 7-388-3-095 from Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the authors.

PY - 2018/9/28

Y1 - 2018/9/28

N2 - BACKGROUND: There is a lack of robust, rigorous mixed methods studies of patient safety culture generally and notably those which incorporate behavioural theories of change. The study aimed to quantify and explain key aspects of patient safety culture which were of most concern to healthcare professionals in Qatar.METHODS: A sequential explanatory mixed methods design of a cross-sectional survey followed by focus groups in Hamad Medical Corporation, Qatar. All doctors, nurses and pharmacists were invited to complete the Hospital Survey on Patient Safety Culture (HSOPS). Respondents expressing interest in focus group participation were sampled purposively, and discussions based on survey findings using the Theoretical Domains Framework (TDF) to explain behavioural determinants.RESULTS: One thousand, six hundred and four questionnaires were received (67.9% nurses, 13.3% doctors, 12.9% pharmacists). HSOPS composites with the lowest levels of positive responses were non-punitive response to errors (24.0% positive) and staffing (36.2%). Specific TDF determinants potentially associated with these composites were social/professional role and identity, emotions, and environmental context and resources. Thematic analysis identified issues of doctors relying on pharmacists to correct their errors and being reluctant to alter the prescribing of fellow doctors. There was a lack of recognition of nurses' roles and frequent policy non-adherence. Stress, workload and lack of staff at key times were perceived to be major contributors to errors.CONCLUSIONS: This study has quantified areas of concern relating to patient safety culture in Qatar and suggested important behavioural determinants. Rather than focusing on changing behaviour at the individual practitioner level, action may be required at the organisational strategic level to review policies, structures (including resource allocation and distribution) and processes which aim to promote patient safety culture.

AB - BACKGROUND: There is a lack of robust, rigorous mixed methods studies of patient safety culture generally and notably those which incorporate behavioural theories of change. The study aimed to quantify and explain key aspects of patient safety culture which were of most concern to healthcare professionals in Qatar.METHODS: A sequential explanatory mixed methods design of a cross-sectional survey followed by focus groups in Hamad Medical Corporation, Qatar. All doctors, nurses and pharmacists were invited to complete the Hospital Survey on Patient Safety Culture (HSOPS). Respondents expressing interest in focus group participation were sampled purposively, and discussions based on survey findings using the Theoretical Domains Framework (TDF) to explain behavioural determinants.RESULTS: One thousand, six hundred and four questionnaires were received (67.9% nurses, 13.3% doctors, 12.9% pharmacists). HSOPS composites with the lowest levels of positive responses were non-punitive response to errors (24.0% positive) and staffing (36.2%). Specific TDF determinants potentially associated with these composites were social/professional role and identity, emotions, and environmental context and resources. Thematic analysis identified issues of doctors relying on pharmacists to correct their errors and being reluctant to alter the prescribing of fellow doctors. There was a lack of recognition of nurses' roles and frequent policy non-adherence. Stress, workload and lack of staff at key times were perceived to be major contributors to errors.CONCLUSIONS: This study has quantified areas of concern relating to patient safety culture in Qatar and suggested important behavioural determinants. Rather than focusing on changing behaviour at the individual practitioner level, action may be required at the organisational strategic level to review policies, structures (including resource allocation and distribution) and processes which aim to promote patient safety culture.

U2 - 10.1371/journal.pone.0204801

DO - 10.1371/journal.pone.0204801

M3 - Article

VL - 13

JO - PloS ONE

JF - PloS ONE

SN - 1932-6203

IS - 9

M1 - e0204801

ER -