Table 4 Example quotes from the interview transcripts
From: Measuring and monitoring patient safety in hospitals in Saudi Arabia
Dimension | Example quotes |
|---|---|
1. Harm | Incident reports “We have the incident reporting systems, you know the OVR [occurrence variance reporting], which is used in 100 % of MOH hospitals at the hospital level” (Risk Manager 2). |
Mortality and morbidity rates “There is the mortality rate which is reviewed monthly. If it is high, then it will be discovered as an issue and an area that requires attention” (Risk Manager 1). | |
Patient safety indicators “Almost all hospitals tend to use patient safety indicators, and even in our hospital they tend to focus on the use of patient safety indicators” (Nurse 5). | |
2. Reliability of safety critical processes | Monitoring compliance to hand hygiene “So, if we take hand hygiene for example, we have in the emergency department a nurse whose main responsibility is to observe staff, how they are adhering to the infection control procedures, and so on (Nurse 2). |
Observation of safety critical behaviours “There are observations whether they are conducted by the nursing manager, medical director, or hospital director” (Risk Manager 1). | |
Monitoring standards “The MOH constructed 3 years ago, has 20 standards that are risky, and that’s the essential safety requirements which is supervised by CBAHI. They are the main evaluator” (quality supervisor 2). | |
3. Sensitivity to operations | Safety walk-rounds “Safety walk-round involve the safety department, nursing department and the quality department” (Quality Supervisor 1). |
4. Anticipation and preparedness | Failure mode and effect analysis (FMEA) to identify risks “Other tools we use is the FMEA [failure mode and effect analysis] and you know FMEA is one of the tools that have been used for a long time in aviation and now used in healthcare field, and it anticipates or predicts future risks to the patient or the organisation, and put solutions for these risks” (Policy Maker 2). |
Staff assessment and credentialing “Staff credentialing which is one of the 20 standards that is applied by MOH and we were evaluated against by CBAHI in the last three years” (Quality Supervisor 2). | |
5. Integration and learning | Analysis and learning from incidents leading to implementation of safety lessons “Sometimes the reoccurrence rates of some safety events indicate to us about the necessity to implement an intervention, a project, budget, modification or take a very quick action to resolve them” (Policy Maker 2). |
Learning from root cause analysis “We advise organisations to use root cause analysis because it is very intense type of analysis that leads you to the root causes of the issue and then putting action plans to prevent reoccurrence of these root causes and treat these root causes to prevent reoccurrence of these incidents” (Doctor 1). | |
Learning and mitigation plans made based on FMEA data “In terms of FMEA, it is prospective, it is something you imagine to happen in the future, and you put the solutions as if these risks happened already, and you train and prepare people to use it. So this is considered future preparations for safety issues” (Policy Maker 2). |