Exploring interagency patient safety policies and strategies in the World Health Organisation Eastern Mediterranean Region (WHO-EMR): A qualitative study of Libya

Dardur, Aseel 2024. Exploring interagency patient safety policies and strategies in the World Health Organisation Eastern Mediterranean Region (WHO-EMR): A qualitative study of Libya. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

ABSTRACT Background Ensuring patient safety is acknowledged as imperative globally. The increasing magnitude of medical harm has led many countries worldwide to develop new legislation, structures, and policies to respond effectively to unsafe care concerns. While improving patient safety holds a prominent position in the healthcare policy priorities of WHO-EMR governments, including Libya, the progress achieved thus far has fallen short of optimal outcomes. The complexity of improving patient safety is underscored by a limited understanding of the safety aspect of healthcare, an underdeveloped research landscape in this domain, and inadequate infrastructure to address patient safety challenges proactively. Compounding these challenges is the absence of holistic, systematic approaches to managing and improving patient safety, further contributing to the suboptimal patient safety practices in the WHO EMR. Aim: To improve understanding of patient safety organisation, management, and concerns in Libya, in conjunction with exploring the effects of interagency working between LMoH, healthcare organisations, and WHO on the organisation and delivery of quality care therein. This understanding, coupled with the global agenda of patient safety espoused by WHO for LMICs countries, was used to generate a context-lens framework for improving patient safety through interagency working in Libya. Research Questions: The study aims to address the following questions: - 1. How is patient safety and managed within the Libyan health system? 2. What patient safety concerns have been perceived by Libyan health policymakers and healthcare managers? 3. How does the interplay and interface between WHO and the Libyan health system's patient safety strategy affect the organisation and delivery of safe care in Libya? 4. What strategies can be effectively employed to address challenges to patient safety in Libya? Methods This research was conducted employing a qualitative strategy of inquiry, specifically utilising the Exploratory-Descriptive Qualitative (EDQ) research approach. The data collection involved 30 interviews and policy document review in Libya. An inductive analysis approach, incorporating content and thematic analysis strategies, was applied to examine and interpret the data. Findings Patient safety organisation, management, and concerns in Libya: Patient safety across the Libyan health system is highly fragmented and loosely regulated, mostly as a result of extreme adversity. An explicit lack of legislation and regulations for patient safety as well as a lack of national quality improvement and patient safety initiatives constituted political and health system factors contributing to patient safety challenges in Libya. Moreover, an absence of policies and strategies for patient safety in Libya xii was also noted, reflecting poor political awareness of the importance of patient safety. Consequently, some healthcare organisations tended to formulate minimum guidelines for patient safety management in practice, although these primarily focus on quality, rather than patient safety directly. The results also indicated that there is no legislative or regulatory mandate for Libyan healthcare organisations to develop or implement proper patient safety systems or strategies, with accountability and mechanisms for developing and implementing patient safety initiatives not clearly defined nor introduced. This resulted in underdeveloped systems and processes to organise and manage patient safety, suggesting an absence of proactive approaches to reducing patient harm. Interagency working in patient safety in Libya: This study pointed to broad challenges to interagency working in patient safety in Libya, including poor understanding of and factors influencing interagency working, such as a lack of a shared vision, no clarity over defined roles and responsibilities, inter-level policy and procedural differences, a lack of commitment, and the implications of political turmoil. Communication in interagency working was poor, contributing to suboptimal interfacing within the context of enhancing the Libyan health system patient safety strategy. In addition, there was a deficiency in interagency coordination in managing health system resources in Libya to maximise effects on patient safety. This compromised the attainment of effective organisation and delivery of quality healthcare in Libya. Moreover, poor management of interagency patient safety-related work emerged as a concern, including a lack of engagement in planning and decision making, challenges associated with implementation, and inadequate oversight. Improving patient safety though enhanced interagency working in Libya: To redress patient safety challenges identified in Libya, the study offered a Libyan context-lens framework for improving patient safety in Libya through enhanced interagency working. This focuses on establishing robust mechanisms for developing interagency working in patient safety, an action plan for patient safety management during emergencies, particularly focusing on implementing the WHO patient safety related frameworks, promoting political accountability for patient safety, leadership, and clinical governance, and research, education, and training in patient safety. Conclusion Patient safety in Libya has received relatively minimal attention, yet the challenges identified therein align with those experienced by many developing and middle-income countries, particularly those facing extreme adversity. These profound challenges have resulted in poor patient safety regulation in Libya and a lack of effective measures to minimise patient harm in healthcare settings. A holistic approach is therefore necessary to address these challenges through enhanced interagency working, taking into account the complex political, organisational, socio-technical, and cultural factors influencing the health system as a whole. To this end, the proposed Libyan context lens framework aims to inform and guide policymakers, WHO, healthcare managers, as well as researchers in their efforts towards improving patient safety in Libya

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	30 July 2024
Last Modified:	08 Oct 2024 11:29
URI:	https://orca.cardiff.ac.uk/id/eprint/170995

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