Evaluation of patient safety in the delivery of care to patients with eye-related problems

MacFarlane, Elinor 2024. Evaluation of patient safety in the delivery of care to patients with eye-related problems. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Patient safety aims to reduce errors in healthcare settings and resulting harms experienced by patients. Patient safety research is well developed across general medicine and in secondary care settings, yet there are few studies within ophthalmology and no research to date into patient safety in primary care optometry in the UK/Wales. Eye care in the UK was recently restructured to relieve pressures on secondary care by managing more complex patients in primary care, necessitating strong governance to understand the safety of the service. A key measure of patient safety is incident reporting from the frontline of the profession, which can provide insights into the safety of a service and identify trends in safety issues. This research contributed to the development of a new patient safety incident reporting system for primary care optometry in Wales and sought to undertake a preliminary analysis of the initial reports in the system, alongside an in-depth exploration of the perceptions on patient safety from both care providers and those receiving care. A mixed-methods approach was used, including through a collaborative workshop with eye care practitioners, interviews with optometrists and patients, incident reports from optometry and focus groups with clinical lead optometrists. The conduct of this research was informed by both Human Factors and Safety Culture theory, with the International Classification for Patient Safety being instrumental in the data collection. It was found that patients face significant delays in care, and often experience severe harm outcomes as a result of eye health-related patient safety incidents. Re-occurring issues involving communication and co-ordination problems, a lack of staffing, and staff members not adhering to guidelines, are thought to frequently contribute to the development of patient safety incidents. Recommendations include ongoing monitoring of safety incidents to provide an indication of priority areas for intervention and supporting primary care practices managing more complex patients to ensure the safety of patient care. Work is needed to develop processes for improvement within organisations when incidents are reported, to further encourage optometrists in Wales to provide detailed incident reports. To facilitate a positive safety culture in eye care, it will be crucial to hear patients’ views, encourage a no blame culture and implement efforts to promote and sustain strong governance.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Optometry and Vision Sciences
Subjects:	R Medicine > RE Ophthalmology
Uncontrolled Keywords:	eye, eyecare, incident, optometry, patient safety, primary care, public health, safety culture
Funders:	KESS 2
Date of First Compliant Deposit:	23 May 2024
Last Modified:	23 May 2024 15:37
URI:	https://orca.cardiff.ac.uk/id/eprint/169126

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