Barriers and Enablers for the Adoption of Patient Safety Tools to Improve Patient Safety in UK Primary Care

Context: Patient safety in primary care lags behind secondary care in terms of research/ measurement and quality improvement work. There are tools available to explore and potentially improve patient safety in primary care. As part of the Patient Safety Toolkit project, a toolkit comprising a selection of these tools was piloted in UK general practice. The barriers and enablers relating to its implementation were explored at participating practices from the perspectives of clinicians and practice managers. Objective: To explore acceptability, feasibility and implementation factors relating to the use of a patient safety toolkit in UK primary care. Views about individual tools and the concept of a patient safety toolkit for use in primary care were obtained. Design: Qualitative study using Framework analysis. Setting: Primary care (general practice) in the Midlands and North-West of England. Participants: 35 general practice staff from 23 practices who piloted the toolkit comprising GP partners, GP registrars, practice managers and nurses participated in semi-structured interviews. Intervention: The patient safety toolkit piloted in this study contained a primary care trigger tool, two safety culture tools, a significant event analysis tool and a patient safety checklist. Participants had access to the complete toolkit but were asked to pilot 2/3 tools. Results: Overall, the participants were positive about using a patient safety toolkit as patient safety in general practice is viewed as paramount. Themes pertaining to acceptability, feasibility and implementation issues relating to individual tools and the overall toolkit were derived. Conclusions: This study enables the exploration of what might influence the use of tools that are designed to identify patient safety issues so that improvements can be made. The findings of this study will be useful to clinicians, managers, commissioners and policy makers who may be involved in encouraging the use of patient safety tools in primary care.