New tool in primary care may effectively identify errors, increase patient safety
The Errors of Care Omission Survey may be effective at identifying critical omissions in the primary care setting, leading to increased prevention of patient harm, according to a study published in the Journal of Patient Safety.
“Most patient safety studies focus on errors of commissions. However, errors of omission occur more frequently yet they are not well-studied or understood,” Lusine Poghosyan, PhD, MPH, RN, associate professor at Columbia University School of Nursing, told Healio Primary Care Today. “We have developed a new tool to measure errors of omission.”
The tool, which originally consisted of 31 items grouped into the subscales of Self-Management Support, Follow-up, Emotional Health Support and Care Integration, allows primary care providers to report on the frequency of missing each item on a five-point scale (“very frequently” to “never”), according to the researchers.
To evaluate the psychometric properties of the tool, researchers used a cross-sectional survey design to mail the tool to 582 primary care providers in New York state (76% women; 397 nurse practitioners; 185 physicians; 50% with more than 10 years of work experience).
The researchers conducted exploratory factor analysis and tested models with one to six factors regarding domains of omission. The coefficient of internal consistency reliability was also calculated for each subscale.
According to the researchers, after testing the exploratory factor analysis models, a four-factor model to represent domains of omission in primary care was selected because of its superior empirical and conceptual fit to the data.
Researchers then removed seven items that performed poorly or were redundant, which left 24 items that measure patient self-management, family engagement, follow-up and care integration domains of omission.
Finally, researchers found that the subscales had acceptable internal consistency reliability.
“It is critically important to recognize what aspects of care are left routinely undelivered so actions can be taken by clinicians to prevent them,” Poghosyan said. “Our tool will help them to do that.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.