TY - JOUR
T1 - Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England
T2 - protocol for a retrospective cross-sectional study
AU - Carson-Stevens, Andrew
AU - McFadzean, Isobel Joy
AU - Purchase, Thomas
AU - Gwyn, Sioned
AU - Hellard, Stuart
AU - Davies, Kate
AU - Ashcroft, Darren M.
AU - Avery, Anthony
AU - Campbell, Stephen
AU - Edwards, Adrian
AU - Flynn, Sandra
AU - Hewson, Thomas
AU - Ibrahim, Saied
AU - Jordan, Melanie
AU - Keers, Richard N.
AU - Millar, Tim
AU - Panagioti, Maria
AU - Sanders, Caroline
AU - Senior, Jane
AU - Stevenson, Caroline
AU - Thompson, Ellie
AU - Walter, Florian
AU - de Wet, Carl
AU - Wainwright, Verity
AU - Shaw, Jenny
N1 - Publisher Copyright:
© 2024 BMJ Publishing Group. All rights reserved.
PY - 2024/12/20
Y1 - 2024/12/20
N2 - Introduction Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.Methods We will undertake a large retrospective cross sectional study involving a case note review of patient healthcare records in 18 prisons in England. Prisons will be purposively sampled for maximum variation of characteristics based on prison category (open, local, training, high security, female), type (publicly and privately run) and prison population size, to sample approximately 15 000 patient records. We will focus on two samples: an enhanced risk sample of prisoners, considered to be at the most risk of healthcare-associated harm, and a random sample of prisoners excluded from the enhanced risk sample, to estimate the incidence of avoidable harm, and express this as 'per 100 000 patients per year'. Avoidable harms will be characterised by type of incident(s), contributory incident(s), contributory factor(s), outcome(s) and severity of harm, prior to a thematic analysis of the relationships between those variables. Univariable and multivariable analyses will be conducted to identify factors associated with avoidable harm.Ethics and dissemination The decision regarding participation by prisons within the study will be voluntary, and their consent to participate may be withdrawn at any time. We will not seek individual patient consent for the retrospective case note review of their records, but if patients respond to publicity about the project and inform us that they do not wish their records to be included, we will adhere to their wishes. We will produce a report for the Department of Health's Policy Research Programme and several peer-reviewed publications. The study has been granted a favourable opinion by Wales Research Ethics Committee 3 (reference 19/WA/0291), Her Majesty's Prison and Probation Service (reference 2019–332) and the Confidentiality Advisory Group (CAG) to access the medical records without individual consent under Section 251 of the National Health Service Act 2006 (reference 19/CAG/0214).
AB - Introduction Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.Methods We will undertake a large retrospective cross sectional study involving a case note review of patient healthcare records in 18 prisons in England. Prisons will be purposively sampled for maximum variation of characteristics based on prison category (open, local, training, high security, female), type (publicly and privately run) and prison population size, to sample approximately 15 000 patient records. We will focus on two samples: an enhanced risk sample of prisoners, considered to be at the most risk of healthcare-associated harm, and a random sample of prisoners excluded from the enhanced risk sample, to estimate the incidence of avoidable harm, and express this as 'per 100 000 patients per year'. Avoidable harms will be characterised by type of incident(s), contributory incident(s), contributory factor(s), outcome(s) and severity of harm, prior to a thematic analysis of the relationships between those variables. Univariable and multivariable analyses will be conducted to identify factors associated with avoidable harm.Ethics and dissemination The decision regarding participation by prisons within the study will be voluntary, and their consent to participate may be withdrawn at any time. We will not seek individual patient consent for the retrospective case note review of their records, but if patients respond to publicity about the project and inform us that they do not wish their records to be included, we will adhere to their wishes. We will produce a report for the Department of Health's Policy Research Programme and several peer-reviewed publications. The study has been granted a favourable opinion by Wales Research Ethics Committee 3 (reference 19/WA/0291), Her Majesty's Prison and Probation Service (reference 2019–332) and the Confidentiality Advisory Group (CAG) to access the medical records without individual consent under Section 251 of the National Health Service Act 2006 (reference 19/CAG/0214).
UR - http://www.scopus.com/inward/record.url?scp=85214025757&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2024-085607
DO - 10.1136/bmjopen-2024-085607
M3 - Article
C2 - 39806709
AN - SCOPUS:85214025757
SN - 2044-6055
VL - 14
JO - BMJ Open
JF - BMJ Open
IS - 12
M1 - e085607
ER -