Non-COVID Patient-safety Incidents Reported by General Practitioners in Time of Lockdown: Protocol for a Cross-sectional Descriptive Study.cRisis

Study Overview
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Brief Summary
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The COVID-19 epidemic is causing a global health crisis. In France, it has imposed a major reorganization of the healthcare system. This emergency reorganization is unprecedented. It involved first, second and third line care. Following this reorganization and from the first days of confinement, a decrease in care activity not related to COVID-19 was observed in médical offices, in emergency services, and in secondary and tertiary care services. This decrease in activity could indicate a decrease in pathologies related to work, transportation or non-COVID-19 infections, due to a favourable effect of lockdown. Nevertheless, some health professionals report the opposite in the media and on social networks, an unusual increase in events (appendicular peritonitis treated late, increase in domestic violence, etc.), while others are surprised by a decrease in activity that is difficult to explain (leukaemia diagnoses by biologists, for example). One hypothesis is that such changes could be related to the reorganisation of the health care system or to the consequences of lockdown. The World Health Organization (WHO) recommends a systematic collection and analysis of patient safety incidents (also called adverse events in France). The objective is to assess the roles of the system and human factors in patient safety, in order to propose changes to the global system and local organisation. In France, there is a system for reporting serious adverse events related to care. Only 4% of the 820 serious adverse events reported in 2018 were reported by primary healthcare professionals (1). However, patient safety incidents in primary care are known to have specific mechanisms, types and mechanisms (2). We hypothesize that the COVID-19 health crisis may have induced unusual patient safety incidents through new mechanisms in a context associating reorganization of the healthcare system and population lockdown. Such a scenario requires the implementation of a massive collection of potential incidents and their systematic and well-structured analysis. Thus, the objective of our study is to describe patient safety incidents related to the reorganization of care and/or lockdown in the context of the COVID-19 health crisis (types, severity, mechanisms) reported by general practitioners in France. HAS. Retour d'expérience sur les événements indésirables graves associés à des soins (EIGS) [Internet]. [cited 2020 Apr 7]. Available from: https://www.has-sante.fr/jcms/c_2882289/fr/retour-d-experience-sur-les-evenements-indesirables-graves-associes-a-des-soins-eigs Carson-Stevens A, Hibbert P, Avery A, Butlin A, Carter B, Cooper A, et al. A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice. BMJ Open. 2015 Dec 1;5(12):e009079.

Official Title
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Non-COVID Patient-safety Incidents Reported by General Practitioners in Time of Lockdown: Protocol for a Cross-sectional Descriptive Study.

Conditions
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Patient Safety

Intervention / Treatment
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* Other: GPs reports of potential patient safety incidents, non-COVID-19 related


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: General practitioners practising in primary care, in France, who have given their consent to receive e-mails from the Collège National des Généralistes Enseignants (CNGE) Any patient undergoing primary care Exclusion Criteria: Other primary health care professionals
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: GPs reports of potential patient safety incidents, non-COVID-19 related|GPs reports of potential patient safety incidents, non-COVID-19 related|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Describe patient safety incidents (types, severity, contributing and correcting factors) - 1000 PSI required | Describe patient safety incidents (types, severity, contributing and correcting factors) by the reorganization of care and/or lockdown reported by French GPs in the context of the COVID-19 health crisis - 1000 PSI required | 6 months | 
| Describe patient safety incidents (types, severity, contributing and correcting factors) - 100 PSI required | Describe patient safety incidents (types, severity, contributing and correcting factors) by the reorganization of care and/or lockdown reported by French GPs in the context of the COVID-19 health crisis - 100 PSI required | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Safety care, COVID, primary care, organization of care