Patient safety and risk management units in primary care: A qualitative study of healthcare providers’ perspectives

Background Primary care accounts for more than half of all adverse events leading to patient harm. Unique patient safety and risk management (PSRM) units have been operating in health maintenance organizations (HMOs) in Israel. Objective To explore healthcare providers’ perspectives regarding the tasks, accomplishments, and recommendations concerning these PSRM units. Methods In-depth qualitative interviews were conducted with 40 healthcare community providers: 10 family physicians, 10 specialist physicians, 10 nurses, and 10 pharmacists. Findings Interviewees identified two of the unit’s main benefits and roles: learning from adverse events and providing backing in litigation cases. They emphasized four of the unit’s accomplishments: sharing lessons learned from adverse event reports; addressing inquiries regarding clinic practice; instructing physicians on how to improve the accuracy of medical record documentation; and providing a user-friendly reporting procedure. They proposed several practices for promoting the reporting of adverse events. Conclusions The study suggests that embedded PSRM units promote the principles of Just Culture and encourage the reporting and discussion of adverse events. It outlines recommendations for practice and policy to support the optimization of PSRM units in primary care. The Israeli PSRM unit may offer an internationally relevant model for strengthening patient safety culture.