Effects of auditing patient safety in hospital care: design of a mixed-method evaluationReport as inadecuate

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BMC Health Services Research

, 13:226

Quality, performance, safety and outcomes


BackgroundAuditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects.

Methods and designOur study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011–July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects.

DiscussionWe report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to early detect unsafe care and improve patient safety continuously.

Trial registrationNetherlands Trial Register NTR: NTR3343

KeywordsHospital Patient safety Safety management Risk management Complications Management system audit Clinical governance Professional practice Adverse events Auditing AbbreviationsPlan–Do–Check–Act PCDAis associated with the US statistician, educator, and consultant W. Edwards Deming, 1900–1993.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-13-226 contains supplementary material, which is available to authorized users.

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Author: Mirelle Hanskamp-Sebregts - Marieke Zegers - Wilma Boeijen - Gert P Westert - Petra J van Gurp - Hub Wollersheim

Source: https://link.springer.com/

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