Haque Ghazal, Asif Fozia, Ahmed Fasih Ali, Ayub Farwa, Syed Sabih Ul Hassan, Pradhan Nousheen Akber, Hameed Malika, Siddiqui Muhammad Muneeb Ullah, Mahmood Shafaq, Zaidi Tahani, Siddiqi Sameen, Latif Asad
Center for Patient Safety, Aga Khan University, Karachi, Pakistan.
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
JMIR Res Protoc. 2024 Mar 27;13:e50532. doi: 10.2196/50532.
The high prevalence of adverse events (AEs) globally in health care delivery has led to the establishment of many guidelines to enhance patient safety. However, patient safety is a relatively nascent concept in low- and middle-income countries (LMICs) where health systems are already overburdened and underresourced. This is why it is imperative to study the nuances of patient safety from a local perspective to advocate for the judicious use of scarce public health resources.
This study aims to assess the status of patient safety in a health care system within a low-resource setting, using a multipronged, multimethod approach of standardized methodologies adapted to the local setting.
We propose purposive sampling to include a representative mix of public and private, rural and urban, and tertiary and secondary care hospitals, preferably those ascribed to the same hospital quality standards. Six different approaches will be considered at these hospitals including (1) focus group discussions on the status quo of patient safety, (2) Hospital Survey on Patient Safety Culture, (3) Hospital Consumer Assessment of Healthcare Providers and Systems, (4) estimation of incidence of AEs identified by patients, (5) estimation of incidence of AEs via medical record review, and (6) assessment against the World Health Organization's Patient Safety Friendly Hospital Framework via thorough reviews of existing hospital protocols and in-person surveys of the facility.
The abovementioned studies collectively are expected to yield significant quantifiable information on patient safety conditions in a wide range of hospitals operating within LMICs.
A multidimensional approach is imperative to holistically assess the patient safety situation, especially in LMICs. Our low-budget, non-resource-intensive research proposal can serve as a benchmark to conduct similar studies in other health care settings within LMICs.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50532.
全球医疗服务中不良事件（AE）的高发生率促使许多指南得以制定，以提高患者安全。然而，在卫生系统已经不堪重负且资源匮乏的低收入和中等收入国家（LMIC），患者安全是一个相对较新的概念。这就是为什么有必要从地方角度研究患者安全的细微差别，以倡导明智地使用稀缺的公共卫生资源。
本研究旨在采用适用于当地情况的多管齐下、多方法的标准化方法，评估资源匮乏环境下医疗系统中的患者安全状况。
我们建议采用目的抽样法，纳入公立和私立、农村和城市、三级和二级医疗机构的代表性组合，最好是那些符合相同医院质量标准的机构。将在这些医院考虑六种不同的方法，包括：（1）关于患者安全现状的焦点小组讨论；（2）患者安全文化医院调查；（3）医疗服务提供者和系统的医院消费者评估；（4）估计患者识别出的不良事件发生率；（5）通过病历审查估计不良事件发生率；（6）通过全面审查现有医院规程和对机构进行实地调查，对照世界卫生组织的患者安全友好医院框架进行评估。
上述研究预计将共同产生关于低收入和中等收入国家众多医院患者安全状况的大量可量化信息。
采用多维度方法对于全面评估患者安全状况至关重要，尤其是在低收入和中等收入国家。我们低成本、非资源密集型的研究方案可作为在低收入和中等收入国家其他医疗环境中开展类似研究的基准。
国际注册报告识别号（IRRID）：PRR1-10.2196/50532
