Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open. 2022 Jan 6;12(1):e050665. doi: 10.1136/bmjopen-2021-050665.
The aim of this study is to develop a better understanding of incident reporting in relation to transitions in care between hospital and care home, and to codesign a systems-level response to safety issues for patients transitioning between hospital and care home.
Two workstreams (W) will run in parallel. W1 will aim to develop a taxonomy of incident reporting in care homes, underpinned by structured interviews (N=150) with care home representatives, scoping review of care home incident reporting systems, and a review of incident reporting policy related to care homes. The taxonomy will be developed using a standardised approach to taxonomy development. W2 will be structured in three phases (P). P1a will consist of ≤40 interviews with care home staff to develop a better understanding of their specific internal systems for reporting incidents, and P1b will include ≤30 interviews with others involved in transitions between hospital and care home. P1a and P1b will also examine the impact of the SARS-CoV-2 pandemic on safe transitions. P2 will consist of a retrospective documentary analysis of care home data relating to resident transitions, with data size and sampling determined based on data sources identified in P1a. A validated data extraction form will be adapted before use. P3 will consist of four validation and codesign workshops to develop a service specification using National Health Service Improvement's service specification framework, which will then be mapped against existing systems and recommendations produced. Framework analysis informed by the heuristic of systemic risk factors will be the primary mode of analysis, with content analysis used for analysing incident reports.
The study has received university ethical approval and Health Research Authority approval. Findings will be disseminated to commissioners, providers and regulators who will be able to use the codesigned service specification to improve integrated care.
本研究旨在深入了解与医院-养老院交接相关的事件报告，并共同设计针对医院-养老院交接患者安全问题的系统级应对措施。
将并行开展两项工作流程（W）。W1 旨在为养老院事件报告制定分类法，其方法为对养老院代表进行结构化访谈（N=150）、对养老院事件报告系统进行范围界定综述，以及对与养老院相关的事件报告政策进行综述。该分类法将采用标准化方法进行开发。W2 将分为三个阶段（P）。P1a 将包括对养老院工作人员进行最多 40 次访谈，以更好地了解他们内部特定的报告事件系统，P1b 将包括对其他参与医院-养老院交接的人员进行最多 30 次访谈。P1a 和 P1b 还将检查 SARS-CoV-2 大流行对安全交接的影响。P2 将包括对与居民交接相关的养老院数据进行回顾性文档分析，根据 P1a 中确定的数据源确定数据大小和抽样。将在使用前对经过验证的数据提取表进行调整。P3 将包括四个验证和共同设计研讨会，以使用国民保健制度改进服务规范框架制定服务规范，然后将其与现有系统和建议进行映射。将使用系统性风险因素启发法进行框架分析，并将内容分析用于分析事件报告。
该研究已获得大学伦理批准和英国健康研究局批准。研究结果将传播给决策者、提供者和监管者，他们将能够使用共同设计的服务规范来改善综合护理。
