Background

Patient safety research is expanding from hospitals to community-based healthcare settings. Knowledge gaps persist among manual therapy professions that may impede patient safety initiatives within musculoskeletal care settings.

Objectives

To describe perceptions of patient safety among chiropractors and physiotherapists who provide spinal manipulation therapy (SMT).

Design

Qualitative descriptive study.

Method

Cross-sectional data were collected using the SafetyNET Survey to Support Quality Improvement. SMT providers (n = 705) in 3 countries completed surveys, with 84 providing written responses to an open-ended question about patient safety. Qualitative thematic analysis described providers’ perceptions about patient safety within their practice.

Results

SMT providers’ perceptions were influenced by professional, patient, and practice setting factors. Five themes and 10 supporting categories were developed. Doing Our Best for Patient Safety concerned Avoiding Mistakes and Prioritizing Safety. Putting Patients First focused on Developing Relationships and Individualizing Care. Working and Learning Together advocated for Interprofessional Communication and Collaborative Learning. Organizing Practice Processes emphasized Standardizing Procedures and Benchmarking Progress. Considering Practitioner Identity highlighted how Recognizing Difference among SMT providers and Challenging Fears of other healthcare professionals and patients about SMT were important for enhancing patient safety.

Conclusion

Findings align with World Health Organization guiding principles that the nature of healthcare settings influence patient safety strategies. Most responses focused on individual strategies to prevent adverse events. However, this approach may overlook the benefits of identifying and documenting adverse events, setting time to discuss adverse events with clinic members, standardizing clinical practices, and building transparent patient safety cultures across healthcare professions and settings.

中文翻译：

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“为患者安全尽我们最大的努力”：在社区环境中与脊柱推拿治疗提供者进行的国际和跨专业定性研究

背景

患者安全研究正在从医院扩展到基于社区的医疗保健环境。手动治疗专业之间的知识差距持续存在，这可能会阻碍肌肉骨骼护理环境中的患者安全举措。

目标

描述提供脊柱推拿疗法 (SMT) 的脊椎按摩师和物理治疗师对患者安全的看法。

设计

定性描述性研究。

方法

横截面数据是使用SafetyNET 调查收集的，以支持质量改进。3 个国家/地区的 SMT 提供者（n = 705）完成了调查，其中 84 名提供了对有关患者安全的开放式问题的书面答复。定性主题分析描述了提供者对其实践中患者安全的看法。

结果

SMT 提供者的看法受到专业、患者和实践环境因素的影响。开发了五个主题和 10 个支持类别。竭尽所能为患者安全有关避免错误和优先排序安全。 将患者放在首位，专注于发展关系和个性化护理。 一起工作和学习提倡跨专业交流和协作学习。组织实践过程强调标准化程序和对标进度。 考虑从业者身份强调了识别SMT 提供者之间的差异以及挑战其他医疗保健专业人员和患者对 SMT 的恐惧对于提高患者安全性很重要。

结论

调查结果符合世界卫生组织的指导原则，即医疗保健环境的性质会影响患者安全策略。大多数反应都集中在预防不良事件的个人策略上。然而，这种方法可能会忽视识别和记录不良事件、安排时间与诊所成员讨论不良事件、标准化临床实践以及在医疗保健专业和环境中建立透明的患者安全文化的好处。