Healthcare staff’s insights into patient safety governance: a study protocol using a methodological pluralistic approach

INTRODUCTION: Healthcare professionals work within an imperfect, multi-faceted system and cannot shoulder the burden of responsibility for unintentional patient harm. Patient safety governance aims to address the challenges of patient safety through monitoring systems and processes to provide assurance of patient safety and quality of care. The evidence suggests that healthcare staff demonstrate mixed views towards patient safety governance processes and varying attitudes towards hospital patient safety climates. STUDY AIMS: This study aims to explore the insights of both healthcare staff and senior healthcare decision makers into patient safety governance and its associated patient safety processes. It aims to capture the attitudes of healthcare staff towards hospital patient safety climates. The researchers intend to identify the gaps in patient safety governance between praxis and theory, with the view of developing recommendations to address these gaps. STUDY DESIGN: This research study is convergent parallel in design, with two study strands occurring simultaneously. It is set in four Irish teaching hospitals located in one regional area. A methodological pluralistic approach, using both qualitative and quantitative methods, will be applied to allow the researchers to adopt the most suitable methodology for data collection, analysis and data interpretation to fulfil the study aims. The study consists of three groups. Qualitative methods will apply to Groups 1 and 2, where consenting participants will be given a choice to engage with a focus group or semi-structured interview. The data collected through these methods will be analysed using the six phases of reflexive thematic analysis. Quantitative methods will apply to Group 3, where consenting participants will complete an electronic questionnaire. The quantitative data will be described in statistical terms using the Stata Now statistical package. Data integration will occur during the data interpretation phase, using a weaving approach in a narrative format where the qualitative and quantitative data findings will be compared thematically. The intention of this study is to broaden the corpus of academic understanding into healthcare staff's insights of patient safety processes and their attitudes towards hospital patient safety climates comparatively to evidence-based best practice for patient safety governance. This study will be carried out using a methodological pluralistic approach, allowing the researchers to choose the most appropriate methods for data collection, analysis and interpretation. The researchers will then identify the current gaps in patient safety governance practice in a small group of Irish hospitals in one healthcare region. These gaps will then be assessed and explored with implementation plans developed to address the gaps, through decision makers and policy development within healthcare.