Measuring and monitoring patient safety in hospitals in the Republic of Ireland

Background: Measuring and monitoring safety (MMS) is critical to the success of safety improvement efforts in healthcare. However, a major challenge to improving safety is the lack of high quality information to support performance evaluation. Aims: The aim of this study was to use Vincent et al.’s MMS framework to evaluate the methods used to MMS in Irish hospitals and make recommendations for improvement. Methods: The first phase of this qualitative study used document analysis to review national guidance on MMS in Ireland. The second phase consisted of semi-structured interviews with key stakeholders on their understanding of MMS. The MMS framework was used to classify the methods identified. Results: Six documents were included for analysis, and 24 semi-structured interviews were conducted with key stakeholders working in the Irish healthcare system. A total of 162 methods of MMS were identified, with one method of MMS addressing two dimensions. Of these MMS methods, 30 (18.4%) were concerned with past harm, 40 (24.5%) were concerned with the reliability of safety critical processes, 16 (9.8%) were concerned with sensitivity to operations, 28 (17.2%) were concerned with anticipation and preparedness, and 49 (30%) were concerned with integration and learning. Conclusions: There are a wide range of methods of MMS in Irish hospitals. It is suggested that there is a need to identify those methods of MMS that are particularly useful in reducing harm and supporting action and improvement and do not place a large burden on healthcare staff to either use or interpret.