Development of a competency framework for healthcare safety investigators: a modified e-Delphi study

Background: Systems-based healthcare safety investigation is an important initiative to improve patient safety worldwide. It requires the use of credible methods and approaches by competent investigators. There is currently no empirically developed competency framework for the healthcare safety investigator role. We developed a competency framework for healthcare safety investigators using an empirical research approach. Method: We used a two-round modified Delphi technique electronically. Two web-based surveys were sent to a panel of experts in healthcare safety investigations in England. The panel rated the relevance of a proposed set of competencies and provided qualitative comments. Strength of agreement was assessed using the interquartile range (IQR), the median and percentage agreement. Participants’ comments were reviewed, with reference to the contemporary healthcare safety literature and practice. Results: A total of 28 participants completed the round-one survey. In round two, 24 of the 28 participants completed the survey. At the end of the round-two survey, 38 competencies and 82 corresponding descriptors were agreed as relevant with high agreement levels (IQR ≤ 1.25, median ≥ 4, percentage agreement ≥ 70%). These were organised in four domains: 1. Personal qualities, 2. Investigation knowledge and skill application, 3. Effective and compassionate engagement, and 4. Manages investigation lifecycle. Conclusion: To our knowledge, this is the first empirically derived competency framework specifically focused on the healthcare safety investigator role. The high levels of agreement among participants give credibility to the findings. This competency framework provides an evidence base to inform the scope and requirements of the healthcare safety investigator workforce.