Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

Abstract Background We identified a need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. The process of development is described from initial expert consensus of a long list of items suitable for inclusion on the checklist through their refinement following staff feedback to the nine items included on the prototype checklist. We then present the results of the pilot of the prototype checklist and a qualitative exploration of staff attitudes to its utility and usability. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the resulting statements summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing and use of IT systems. A 13 item checklist was trialled in 16 practices resulting in a 9 item prototype tool, which was tested in 8 practices. Qualitative data on the utility and usability of the prototype checklist was collected with a series of semi-structured interviews. Results In testing the prototype 4 of 9 items on the checklist were achieved 100% of the time, 3 items 87% of the time and 2 items 75% of the time. Participants expressed concern about the utility and implementation of checklists in general. However, the prototype was praised for its brevity and its use as a learning tool and ‘final check’ on elements of safety that the practices considered important. Conclusions The concise patient safety checklist tool, specifically designed for general practice, has been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Practice managers/GP partners should find it a useful tool to monitor safety within the practice.