Centre for Quality Improvement and Patient Safety, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
Department of Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada.
BMJ Open. 2023 Jul 31;13(7):e072706. doi: 10.1136/bmjopen-2023-072706.
Hospital safety monitoring systems are foundational to how adverse events are identified and addressed. They are well positioned to bring equity-related safety issues to the forefront for action. However, there is uncertainty about how they have been, and can be, used to achieve this goal. We will undertake a critical interpretive synthesis (CIS) to examine how equity is integrated into hospital safety monitoring systems.
This review will follow CIS principles. Our initial compass question is: How is equity integrated into safety monitoring systems? We will begin with a structured search strategy of hospital safety monitoring systems in CINAHL, EMBASE, MEDLINE and PsycINFO for up to May 2023 to identify papers on safety monitoring systems generally and those linked to equity (eg, racism, social determinants of health). We will also review reference lists of selected papers, contact experts and draw on team expertise. For subsequent literature searching stages, we will use team expertise and expert contacts to purposively search the social science, humanities and health services research literature to support the development of a theoretical understanding of our topic. Following data extraction, we will use interpretive processes to develop themes and a critique of the literature. The above processes of question formulation, article search and selection, data extraction, and critique and synthesis will be iterative and interactive with the goal to develop a theoretical understanding of equity in hospital monitoring systems that will have practice-based implications.
This review does not require ethical approval because we are reviewing published literature. We aim to publish findings in a peer-reviewed journal and present at conferences.
医院安全监测系统是识别和处理不良事件的基础。它们非常适合将与公平相关的安全问题提上日程,采取行动。然而,对于它们如何以及可以用来实现这一目标,还存在不确定性。我们将进行批判性解释性综合(CIS)研究,以考察公平是如何融入医院安全监测系统的。
本综述将遵循 CIS 原则。我们的初始指南针问题是:公平是如何融入安全监测系统的?我们将从 CINAHL、EMBASE、MEDLINE 和 PsycINFO 中进行针对医院安全监测系统的结构化搜索策略,以查找一般安全监测系统以及与公平(例如种族主义、健康的社会决定因素)相关的论文,时间截至 2023 年 5 月。我们还将审查选定论文的参考文献列表,与专家联系,并利用团队专业知识。在随后的文献搜索阶段,我们将利用团队专业知识和专家联系,有针对性地搜索社会科学、人文学科和卫生服务研究文献,以支持对我们主题的理论理解的发展。在提取数据后,我们将使用解释性过程来开发主题,并对文献进行批判。问题制定、文章搜索和选择、数据提取以及批判和综合的上述过程将是迭代和互动的,目的是对医院监测系统中的公平形成理论理解,从而具有实践意义。
本综述不需要伦理批准,因为我们正在审查已发表的文献。我们的目标是在同行评议的期刊上发表研究结果,并在会议上展示。