The aims of the study are to develop a better understanding of incident reporting in relation to transitions in care between hospital and care home, and to co-design a systems-level response to safety issues for patients transitioning between hospital and care home. To meet these aims, the study has the following seven objectives:
- Investigate, using desk-based approaches, what policies exist for incident reporting, the technology used to incident report, and the types of data captured within incident reports.
- Develop a typology of approaches to incident reporting within care homes
- Identify, using qualitative methods, the socio-technical and cultural determinants of incident reporting in care homes in relation to patient transitions, including how care homes report safety incidents and how decisions are made to report or not.
- Conduct a retrospective documentary content analysis of incident reports (and similar systems) relating to patient transitions into the care home
- Co-design with relevant stakeholders a service specification for an integrated system-response to safety incident reporting
- Map the co-designed service specification against existing systems to produce recommendations for implementation.
- Investigate how the COVID-19 pandemic has influenced the management of safe transitions in care
What are the intended outcomes?
Using what we learn throughout the study, we will jointly design a new system for learning from safety incidents. This new system will be compared with existing systems and recommendations will be made for how it can be put into practice. During the course of the study we intend to work with policy-makers to ensure that informs both policy and practice.