Yardley, I;
Yardley, S;
Williams, H;
Carson-Stevens, A;
Donaldson, LJ;
(2018)
Patient safety in palliative care: A mixed-methods study of reports to a national database of serious incidents.
Palliative Medicine
, 32
(8)
pp. 1353-1362.
10.1177/0269216318776846.
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Abstract
Background: Patients receiving palliative care are vulnerable to patient safety incidents but little is known about the extent of harm caused or the origins of unsafe care in this population. Aim: To quantify and qualitatively analyse serious incident reports in order to understand the causes and impact of unsafe care in a population receiving palliative care. Design: A mixed-methods approach was used. Following quantification of type of incidents and their location, a qualitative analysis using a modified framework method was used to interpret themes in reports to examine the underlying causes and the nature of resultant harms. Setting and participants: Reports to a national database of ‘serious incidents requiring investigation’ involving patients receiving palliative care in the National Health Service (NHS) in England during the 12-year period, April 2002 to March 2014. Results: A total of 475 reports were identified: 266 related to pressure ulcers, 91 to medication errors, 46 to falls, 21 to healthcare-associated infections (HCAIs), 18 were other instances of disturbed dying, 14 were allegations against health professions, 8 transfer incidents, 6 suicides and 5 other concerns. The frequency of report types differed according to the care setting. Underlying causes included lack of palliative care experience, under-resourcing and poor service coordination. Resultant harms included worsened symptoms, disrupted dying, serious injury and hastened death. Conclusion: Unsafe care presents a risk of significant harm to patients receiving palliative care. Improvements in the coordination of care delivery alongside wider availability of specialist palliative care support may reduce this risk.
| Type: | Article |
|---|---|
| Title: | Patient safety in palliative care: A mixed-methods study of reports to a national database of serious incidents |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/0269216318776846 |
| Publisher version: | https://doi.org/10.1177/0269216318776846 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Health Care Sciences & Services, Public, Environmental & Occupational Health, Medicine, General & Internal, General & Internal Medicine, Patient safety, palliative care, palliative medicine, medical errors, risk management, qualitative research, QUALITATIVE DATA, CANCER-PATIENTS, ERRORS, HOME, PERSPECTIVES, EXPERIENCES, SUICIDE, LIFE, END |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Marie Curie Palliative Care |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10091627 |
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