This project examined the vulnerability of eight groups of individuals to health-care errors.
Lead: Professor Joanne Travaglia, Faculty of Health
Duration: 2017-2019
The groups involved were: people from culturally and linguistically diverse (CALD) backgrounds; older people; lesbian, gay, bisexual, transgender, queer and inter-sex (LGBTQI+) people; First Nations peoples; people who are homeless; people living in rural and remote communities; prisoners; and people with intellectual disabilities.
The project took a wide-ranging and original approach to understanding the social context of patient safety, where discrimination and stereotyping may affect not only access to health care but also the safety of that care. Researchers from the Centre for Health Services Management systematically searched peer-reviewed literature, summarising and synthesising evidence on the differential risk of harm – distinguishing between errors of commission and the more elusive errors of omission.
Instances of suboptimal care included misdiagnosis, less active or inappropriate treatment, preventable readmissions and inappropriate prescribing. The review studies also highlighted the intersectional nature of patient safety, where individuals experience poor treatment because they belong to two or more vulnerable groups – for example, First Nations people living in remote locations.
The studies selected for the eight reviews used a wide range of qualitative and quantitative methodologies. The diversity of research designs, settings and outcome variables precluded any numerical or meta-analysis of results. Consequently, the project synthesised the findings narratively. The team also conducted an overview of significant government inquiries into patient safety breaches in four countries.
What impact did we create?
The eight reviews identified interventions aimed at improving safety outcomes for vulnerable individuals – for example, measures to reduce oversubscribing of drugs for older people. The next steps will be to empirically establish the extent and rate of additional risk, and to work with communities and clinicians to develop a range of strategies to reduce these risks however, and wherever, possible.
Who did we work with?
- Dr Deborah Debono, UTS Faculty of Health
Funding Support
- Agency for Clinical Innovation
- Clinical Excellence Commission
Network Research Themes
- Social Justice, Diversity and Equity
- Health and Wellbeing