Objectives: Current study explores the potential of the safety rating scale in order to determine the surplus value for evidence based practise. This study wants to contribute to this knowledge gape by exploring the safety scale by analysing the change between two safety ratings. First, the absolute change in safety is investigated. Secondly the study explores to what extent family background characteristics and case management characteristics determine the extent of change in perceived safety. Materials and Methods: The study analysed 105 Dutch child protection cases who had registration files with filled out LIRIK checklist, Action Plan and additional baseline safety and end safety measure as perceived by case managers. Results: On average perceived safety increased from an insufficient level to sufficient level. Significant regression coefficients with larger changes for primary school children (6 - 12 years) and lower changes for children within the ‘socio economic problems cluster’. The results reveal significant vulnerability for preschool children and families attending the socio-economic cluster due to limited improvement. Conclusion: According to this study the safety measure can be of value to outcome monitoring. The safety measure is a practical measure that reflects on the current state of safety within a family according to professionals and can be used on several occasions during case management. In addition, on aggregated level pre and post measures can be analysed for quality management purpose. Further exploration of this measure is needed. Publishers article: https://www.ecronicon.com/ecpe/ECPE-10-00873.php
BACKGROUND: During transitions from hospital to home, up to half of all patients experience medication-related problems, such as adverse drug events. To reduce these problems, knowledge of patient experiences with medication use during this transition is needed. This study aims to identify the perspectives of patients on barriers and facilitators with medication use, during the transition from hospital to home.METHODS: A qualitative study was conducted in 2017 among patients discharged from two hospitals using a semi-structured interview guide. Patients were asked to identify all barriers they experienced with medication use during transitions from hospital to home, and facilitators needed to overcome those barriers. Data were analyzed following thematic content analysis and visualized using an "Ishikawa" diagram.RESULTS: In total, three focus groups were conducted with 19 patients (mean age: 70.8 (SD 9.3) years, 63% female). Three barriers were identified; lack of personalized care in the care continuum, insufficient information transfer (e.g. regarding changes in pharmacotherapy), and problems in care organization (e.g. medication substitution). Facilitators to overcome these barriers included a personal medication-counselor in the care continuum to guide patients with medication use and overcome communication barriers, and post-discharge follow-up care (e.g. home visits from healthcare providers).CONCLUSIONS: During transitions from hospital to home patients experience individual-, healthcare provider- and organization level barriers. Future research should focus on personal-medication counselors in the care continuum and post-discharge follow-up care as it may overcome communication, emotional, information and organization barriers with medication use.
Various tools for safety performance measurement have been introduced in order to fulfil the need for safety monitoring in organisations, which is tightly related to their overall performance and achievement of their business goals. Such tools include accident rates, benchmarking, safety culture and climate assessments, cost-effectiveness studies, etc. The current work reviews the most representative methods for safety performance evaluation that have been suggested and applied by a variety of organisations, safety authorities and agencies. This paper discusses several viewpoints of the applicability, feasibility and appropriateness of such tools, based on the viewpoints of managers and safety experts involved in a relevant research that was conducted in a large aviation organisation. The extensive literature cited, the discussion topics, along with the conclusions and recommendations derived, might be considered by any organisation that seeks a realistic safety performance assessment and establishment of effective measurement tools.
