How do chiropractors manage clinical risk? A questionnaire study.

Area of Science:

• Chiropractic Practice
• Patient Safety
• Risk Management in Healthcare

Background:

• Limited research exists on how chiropractors ensure patient safety and manage clinical risks during daily practice.
• Existing literature predominantly focuses on adverse events rather than proactive safety measures.
• Understanding chiropractors' risk management strategies and perceptions of safety climate is crucial for the profession.

Purpose of the Study:

• To investigate how chiropractors manage potentially risky clinical scenarios.
• To assess chiropractors' perceptions of the safety climate within their practice settings.
• To determine if an observable culture of safety exists within the chiropractic profession.

Main Methods:

• An online questionnaire was distributed to 260 Swiss chiropractors and 1258 UK members of The Royal College of Chiropractors.
• Participants responded to four clinical case scenarios, selecting from nine management options.
• Safety climate was measured using 23 statements across six safety dimensions, with responses analyzed quantitatively.

Main Results:

• Response rates were 76% for Swiss participants and 31% for UK participants.
• A general trend showed Swiss and UK chiropractors re-evaluating care for unsuccessful, contraindicated, harmful, or worsening patient conditions.
• Stopping treatment and incident reporting were unlikely actions; female chiropractors appeared more risk-averse.

Conclusions:

• Swiss and UK chiropractors predominantly manage risky clinical scenarios through case re-evaluation.
• Barriers likely contribute to the low likelihood of safety incident reporting, despite positive perceptions of local communication and openness.
• Positive attitudes towards key clinic safety aspects suggest a developing safety culture in Swiss and UK chiropractic professions.