Delphi analysis of how the practice team should organise event analysis in primary care

Significant event analysis is a common quality improvement activity in UK general practice (GP). How well do general practice (GP) teams conduct their analyses? There is little guidance and no measuring tool. This is a Delphi analysis among Scottish multidisciplinary primary care team members to establish a set of quality indicators by which practices can self-assess their practice processes in conducting their event analyses.

A Delphi method specifically for identifying quality indicators in healthcare was used. Purposeful selection was of primary care team members with known experience of significant event analysis; informed participants. After setting a consensus score, 29 items for the first round Delphi survey, drawn from the literature, were sent out with the ability to comment on each. The second Delphi round contained those items which had passed the consensus score, the aggregated comments on those items and any suggestions for new items.

Of 24 informed participants approached, 10 (37.5%) agreed to undertake the full cycle of the Delphi process. 17 items from the first Delphi survey passed the consensus score with one additional item suggested. With the amalgamation of items, 16 statements were presented in the second Delphi, of which 15 passed the consensus score.

Learnings from our Delphi are that practitioners prefer the term 'learning event analysis' to 'significant event analysis', and that practice nurses may need specific encouragement to become more involved in event analysis. There is reluctance to involve patients or patient representatives in the event analysis itself. Engagement in well-conducted event analysis strengthens the whole practice team.