The applicability of a structured learning programme focusing on improving observational competencies to strengthen patient safety: a qualitative study with professionals in primary healthcare services

一项旨在提高观察能力、加强患者安全的结构化学习计划的适用性:一项针对基层医疗服务专业人员的定性研究

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Abstract

BACKGROUND: Primary healthcare in many Western countries faces increased patient care needs due to shorter hospital stays and an ageing population suffering from complex conditions. A shortage of qualified professionals jeopardises the quality of care in primary healthcare settings. Literature indicates that the quality of care and the occurrence of adverse events are linked to the observational competencies of healthcare professionals. In Norway, patient safety competence programmes, such as ClinObsMunicipality, have been developed to improve healthcare professionals' observational competencies in recognising and responding to clinical deterioration, thereby ensuring safety in primary healthcare. In this study, we aimed to explore and describe how healthcare professionals experienced and perceived learning and training in this competence-building programme. Specifically, we focused on their reflections on its applicability in clinical practice. DESIGN: Aqualitative study was conducted. In preparing the manuscript, we applied the checklist guidelines for the Consolidated Criteria for Reporting Qualitative Research. METHOD: The study is based on 17 individual interviews with healthcare professionals from different primary healthcare settings. Data were analysed using Malteruds' systematic text condensation, a thematic cross-case analysis. RESULTS: We identified three categories illustrating how healthcare professionals experienced learning and training in the competence-building programme and its applicability for clinical practice: (1) Shared base of competence through practice-based group-learning with colleagues; (2) Enhanced clinical communication: The impact and applicability of standardised language; (3) From Colleagues to team: Increased autonomy and collaboration. CONCLUSION: This study highlights that healthcare professionals experienced learning and training in the competence programme as applicable to their clinical practice. Group-learning activities fostered a supportive environment where participants could engage with cases and scoring tools relevant to their clinical settings. This approach enhanced their observational competencies, deepened their understanding of team roles and strengthened interprofessional communication and collaboration, which may positively impact patient care and safety in primary healthcare settings. While the programme empowered healthcare professionals through increased autonomy, it also uncovered hesitance in critical situations among some participants, suggesting complex awareness and the urgency of timely interventions.

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