Identifying patient safety research priorities in Estonia: results of a Delphi consensus study

Patient safety research aims to create new knowledge and find evidence-based solutions to improve patient safety and reduce avoidable adverse events in healthcare.1 More than a decade ago, the WHO recommended that all countries identify, analyse and prioritise areas where patient safety research could reduce avoidable harm and improve healthcare systems.2 However, only a few articles about this topic have been published,3–6 and only one examined research priorities for patient safety at the national level.6The Patient Safety Research and Development Centre (PSR&DC) at the Faculty of Medicine of the University of Tartu plays a national role in introducing research-based patient safety practices in Estonia. Its work group previously identified patient safety research in Estonia as limited, fragmented and unsystematic.7 There is not enough reliable information to support patient safety practices in the Estonian healthcare system. As a part of the Patient Safety Research and Development Strategy 2022–2026 by PSR&DC, this study aimed to collect expert judgements and determine a consensus for patient safety research priorities in Estonia.</p

Health promotion services for lifestyle development within a UK hospital – Patients' experiences and views

<p>Abstract</p> <p>Background</p> <p>UK public health policy requires hospitals to have in place health promotion services which enable patients to improve their health through adopting healthy behaviours, i.e. health education. This study investigated hospitalised patients' experiences of health education for smoking, alcohol use, diet, physical activity, and weight, and their views concerning the appropriateness of hospitals as a setting for the delivery of health education services.</p> <p>Methods</p> <p>Recently discharged adult hospital patients (n = 322) were sent a questionnaire asking about their smoking, alcohol use, diet, physical activity, and weight. For each of these risk factors, participants were asked whether they agreed with screening for the risk factor, whether they received health education, whether it was "helpful", and if they wanted to change their behaviour. Participants were also asked a set of general questions concerning health education within hospitals.</p> <p>Results</p> <p>190 patients responded (59%). Over 80% agreed with screening for all risk factors. 80% of smokers, 52% consuming alcohol above recommended limits, 86% of obese, 66% consuming less than five fruit and vegetables a day, and 61% of physically inactive participants wanted to change their respective behaviour. However only a third reported receiving health education. While over 60% of patients wanted health education around discharge, the majority of those receiving health education did so at admission. The majority agreed that "hospital is a good place for patients to receive" health education (87%) and that "the hospital should provide patients with details of community organisations that provide" health education (83%). Only a minority (31%) reported a preference for health education from their GP instead of hospital.</p> <p>Conclusion</p> <p>While the delivery of health education to patients within hospital was poor, hospitals are viewed by patients as an appropriate, and in some cases preferred setting for the screening of risk factors and delivery of health education.</p

An inter-country comparison of unofficial payments: results of a health sector social audit in the Baltic States

<p>Abstract</p> <p>Background</p> <p>Cross-country comparisons of unofficial payments in the health sector are sparse. In 2002 we conducted a social audit of the health sector of the three Baltic States.</p> <p>Methods</p> <p>Some 10,320 household interviews from a stratified, last-stage-random, sample of 30 clusters per country, together with institutional reviews, produced preliminary results. Separate focus groups of service users, nurses and doctors interpreted these findings. Stakeholder workshops in each country discussed the survey and focus group results.</p> <p>Results</p> <p>Nearly one half of the respondents did not consider unofficial payments to health workers to be corruption, yet one half (Estonia 43%, Latvia 45%, Lithuania 64%) thought the level of corruption in government health services was high. Very few (Estonia 1%, Latvia 3%, Lithuania 8%) admitted to making unofficial payments in their last contact with the services. Around 14% of household members across the three countries gave gifts in their last contact with government services.</p> <p>Conclusion</p> <p>This social audit allowed comparison of perceptions, attitudes and experience regarding unofficial payments in the health services of the three Baltic States. Estonia showed least corruption. Latvia was in the middle. Lithuania evidenced the most unofficial payments, the greatest mistrust towards the system. These findings can serve as a baseline for interventions, and to compare each country's approach to health service reform in relation to unofficial payments.</p