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    Identifying safety practices perceived as low-value: an exploratory survey of healthcare staff in the UK and Australia

    Halligan, Daisy, Janes, Gillian ORCID logoORCID: https://orcid.org/0000-0002-1609-5898, Conner, Mark, Albutt, Abigail, Debono, Deborah, Carland, Jane, Sheppard-Law, Suzanne, Taylor, Natalie, Middleton, Sandy, McInnes, Elizabeth, Ferguson, Caleb and Lawton, Rebecca (2023) Identifying safety practices perceived as low-value: an exploratory survey of healthcare staff in the UK and Australia. Journal of Patient Safety, 19 (2). pp. 143-150. ISSN 1549-8417

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    Objectives: Up to 30% of healthcare spending is considered unnecessary and represents systematic waste. While much attention has been given to low-value clinical tests and treatments, much less has focused on identifying low-value safety practices in healthcare settings. With increasing recognition of the problem of ‘safety clutter’ in organisations, it is important to consider de-implementing safety practices that do not benefit patients, to create the time needed to deliver effective, person-centred and safe care. This study surveyed healthcare staff to identify safety practices perceived to be of low-value. Methods: Purposive and snowball sampling was used. Data collection was conducted from April 2018 to November 2019 (UK) and May 2020 to November 2020 (Australia). Participants completed the survey online or in hard copy to identify practices they perceived to not contribute to safe care. Responses were analysed using content and thematic analysis. Results: A total of 1,394 responses from 1,041 participants were analysed. 663 responses were collected from 526 UK participants and 515 Australian participants contributed 731 responses. Frequently identified categories of practices identified included ‘paperwork’, ‘duplication’ and ‘intentional rounding’. Five cross-cutting themes (e.g. covering ourselves) offered an underpinning rationale for why staff perceived the practices to be of low-value. Conclusions: Staff identified safety practices that they perceived to be low-value. In healthcare systems under strain, removing existing low-value practices should be a priority. Careful evaluation of these identified safety practices is required to determine whether they are appropriate for de-implementation and, if not, to explore how to better support healthcare workers to perform them.

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