چکیده (انگلیسی):

Background:The majority of patient contacts occur in general practice but general practice patient safety has
been poorly described and under-researched to date compared to hospital settings. Our objective was to produce
a set of patient safety tools and indicators that can be used in general practices in any healthcare setting and
develop a‘toolkit’ of feasible patient safety measures for general practices in England.
Methods:A RAND/UCLA Appropriateness Method exercise was conducted with a panel of international experts in
general practice patient safety. Statements were developed from an extensive systematic literature review of patient
safety in general practice. We used standard RAND/UCLA Appropriateness Method rating methods to identify
necessary items for assessing patient safety in general practice, framed in terms of the Structure-Process-Outcome
taxonomy. Items were included in the toolkit if they received an overall panel median score of ≥7 with agreement
(no more than two panel members rating the statement outside a 3-point distribution around the median).
Results:Of 205 identified statements, the panel rated 101 as necessary for assessing the safety of general practices. Of
these 101 statements, 73 covered structures or organisational issues, 22 addressed processes and 6 focused on outcomes.
Conclusions:We developed and tested tools that can lead to interventions to improve safety outcomes in general
practice. This paper reports the first attempt to systematically develop a patient safety toolkit for general practice, which
has the potential to improve safety, cost effectiveness and patient experience, in any healthcare system.