Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium.
Department of Family Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Int J Environ Res Public Health. 2022 Aug 24;19(17):10515. doi: 10.3390/ijerph191710515.
The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
初级保健（PC）的日常工作因 COVID-19 大流行而发生了重大变化。教学实践需要适应临床工作和教学，以确保教学过程的继续，同时保持安全和高质量的护理。我们的研究旨在调查作为培训实践对与 PC 实践安全文化相关的多项不同结果的影响。PRICOV-19 是一项多国家的横断面研究，研究了 38 个国家在大流行期间如何组织 PC 实践。数据收集于 2020 年 11 月至 2021 年 12 月。我们将实践分为培训和非培训，并选择与安全文化相关的结果：安全实践管理、社区外展、专业幸福感和遵守协议。建立混合效应回归模型来分析作为培训实践对每个结果的影响，同时控制相关混杂因素。在参与的实践中，2886 个（56%）是非培训实践，2272 个（44%）是培训实践。作为培训实践与不良心理健康事件的风险降低显著相关（OR：0.83；CI：0.70-0.99）、与患者流程相关的安全措施数量增加（Beta：0.17；CI：0.07-0.28）、报告的安全事件数量增加（RR：1.12；CI：1.06-1.19）和会议保护时间增加（Beta：0.08；CI：0.01-0.15）。在外展倡议、分诊信息可用性、使用电话协议或感染预防措施和设备可用性方面没有发现显著关联。培训实践被发现具有比非培训实践更强的安全文化。这些结果具有重要的政策意义，因为让更多的 PC 实践参与教育可能是提高一般实践质量和安全性的有效途径。
