Liberati, Elisa Giulia, Tarrant, Carolyn, Willars, Janet, Draycott, Tim, Winter, Cathy, Kuberska, Karolina, Paton, Alexis, Marjanovic, Sonja, Leach, Brandi, Lichten, Catherine, Hocking, Lucy, Ball, Sarah, Dixon-Woods, Mary, the SCALING Authorship Group, Bevens, Cathy, Brigante, Lia, Brintworth, Kate, Burt, Jenni, Carlile, Carol, Chaffer, Denise, Chakrabarti, Sanhita, Christmas, Tracey, Clark-Ward, Victoria, Clements, Sophie, Crofts, Joanna, Davis, Paul, Deacon, Lesley, Donald, Fiona, Duckett, Rachel, Duffy, James M.N., Dyson, Charlotte, Edwards, Sian, Farrar, Diane, Fogarty, Matthew, Forrester, Mandy, Fowler, Aidan, Haddon, Richard, Halliday, Robyn, Harmer, Clea, Houghton, Jill, Johnston, Carolyn, Jolly, Matthew, Kaur-Desai, Tejinder, Kelly, Tony, Kirby, Joy, Leslie, Karin, Lewis, Sandy, Lindley, Amanda, Locock, Louise, Lucas, Nuala, Lyndon, Audrey, Mackintosh, Nicola, Matthews, Joanne, McCulloch, Bernadette, McHugh, Siobhan, Merritt, Sarah, Morris, Edward, Nicol, Alison, Patil, Anita, Percival, Rebecca, Pradhan, Farrah, Punch, Daniel, Rowley, Amanda, Roy, Catherine, Russell, Elizabeth, Rzewuska, Magdalena, Simpson, Kathleen, Titcombe, James, Upton, Michele, Walton, Gill, Wells-Munro, Sascha, Wilson, Caitlin, Wilson-Crellin, Rebecca, Wright, Alison and Yau, Christopher (2021). Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation. BMJ Quality and Safety, 30 (6), pp. 444-456.
Abstract
Background: Reducing avoidable harm in maternity services is a priority globally. As well as learning from mistakes, it is important to produce rigorous descriptions of ‘what good looks like’. Objective: We aimed to characterise features of safety in maternity units and to generate a plain language framework that could be used to guide learning and improvement. Methods: We conducted a multisite ethnography involving 401 hours of non-participant observations 33 semistructured interviews with staff across six maternity units, and a stakeholder consultation involving 65 semistructured telephone interviews and one focus group. Results: We identified seven features of safety in maternity units and summarised them into a framework, named For Us (For Unit Safety). The features include: (1) commitment to safety and improvement at all levels, with everyone involved; (2) technical competence, supported by formal training and informal learning; (3) teamwork, cooperation and positive working relationships; (4) constant reinforcing of safe, ethical and respectful behaviours; (5) multiple problem-sensing systems, used as basis of action; (6) systems and processes designed for safety, and regularly reviewed and optimised; (7) effective coordination and ability to mobilise quickly. These features appear to have a synergistic character, such that each feature is necessary but not sufficient on its own: the features operate in concert through multiple forms of feedback and amplification. Conclusions: This large qualitative study has enabled the generation of a new plain language framework—For Us—that identifies the behaviours and practices that appear to be features of safe care in hospital-based maternity units.
Publication DOI: | https://doi.org/10.1136/bmjqs-2020-010988 |
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Divisions: | College of Business and Social Sciences > School of Social Sciences & Humanities College of Business and Social Sciences > School of Social Sciences & Humanities > Sociology and Policy College of Business and Social Sciences > School of Social Sciences & Humanities > Centre for Critical Inquiry into Society and Culture (CCISC) College of Business and Social Sciences > School of Social Sciences & Humanities > Centre for Health and Society Aston University (General) |
Additional Information: | © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. Funding: Health Foundation (THIS Institute), Wellcome Trust Senior Investigator Award (WT097899MA) and NIHR Senior Investigator Award (NF- SI-0617-10026). |
Uncontrolled Keywords: | healthcare quality improvement,obstetrics and gynecology,patient safety,qualitative research,Health Policy |
Publication ISSN: | 2044-5423 |
Last Modified: | 19 Dec 2024 08:17 |
Date Deposited: | 30 Sep 2020 08:14 |
Full Text Link: | |
Related URLs: |
https://quality ... jqs-2020-010988
(Publisher URL) http://www.scop ... tnerID=8YFLogxK (Scopus URL) |
PURE Output Type: | Article |
Published Date: | 2021-05-19 |
Published Online Date: | 2020-09-25 |
Accepted Date: | 2020-08-21 |
Submitted Date: | 2020-02-04 |
Authors: |
Liberati, Elisa Giulia
Tarrant, Carolyn Willars, Janet Draycott, Tim Winter, Cathy Kuberska, Karolina Paton, Alexis ( 0000-0003-4310-6983) Marjanovic, Sonja Leach, Brandi Lichten, Catherine Hocking, Lucy Ball, Sarah Dixon-Woods, Mary the SCALING Authorship Group Bevens, Cathy Brigante, Lia Brintworth, Kate Burt, Jenni Carlile, Carol Chaffer, Denise Chakrabarti, Sanhita Christmas, Tracey Clark-Ward, Victoria Clements, Sophie Crofts, Joanna Davis, Paul Deacon, Lesley Donald, Fiona Duckett, Rachel Duffy, James M.N. Dyson, Charlotte Edwards, Sian Farrar, Diane Fogarty, Matthew Forrester, Mandy Fowler, Aidan Haddon, Richard Halliday, Robyn Harmer, Clea Houghton, Jill Johnston, Carolyn Jolly, Matthew Kaur-Desai, Tejinder Kelly, Tony Kirby, Joy Leslie, Karin Lewis, Sandy Lindley, Amanda Locock, Louise Lucas, Nuala Lyndon, Audrey Mackintosh, Nicola Matthews, Joanne McCulloch, Bernadette McHugh, Siobhan Merritt, Sarah Morris, Edward Nicol, Alison Patil, Anita Percival, Rebecca Pradhan, Farrah Punch, Daniel Rowley, Amanda Roy, Catherine Russell, Elizabeth Rzewuska, Magdalena Simpson, Kathleen Titcombe, James Upton, Michele Walton, Gill Wells-Munro, Sascha Wilson, Caitlin Wilson-Crellin, Rebecca Wright, Alison Yau, Christopher |