General practices generally differ from each other with regard to patient safety. We see that this can be improved on a number of points. In general practice, for example, more attention could be paid to kidney damage among the elderly and to the use of anti-inflammatories and blood thinners by patients with reduced kidney function. This is the conclusion of research by Nivel that was recently published in the journal Huisarts & Wetenschap.
We have defined six ‘safety indicators’ for signaling possible areas for improvement with regard to patient safety in general practices. We calculated the value of these six indicators using routinely registered care data from general practices that participate in Nivel Primary Care Registrations.
Points for improvement of patient safety at GP practices
The following points for improvement emerged from the calculation of the six indicators:
- more consistent monitoring of kidney damage in the elderly
- more attention to the use of NSAIDs (anti-inflammatory drugs that also have an analgesic and antipyretic effect) by patients with reduced kidney function
- more attention to the use of salicylates (medicines that counteract the action of blood platelets and thus have a blood-thinning effect) by patients with reduced kidney function
- more attention to the use of NSAIDs in patients with heart failure
- prevent chronic use of antacids
- caution in prescribing benzodiazepines to the elderly
Mirror information can provide tools for improvement
There were clear differences between GP practices on the six calculated indicators; the variation between practices was up to 20%. This can depend on many factors. Insofar as the variation that exists between practices cannot be reduced to practice characteristics, GPs would do well to reflect on the six defined indicators. Our ‘mirror information’ can support GP practices in developing policy to improve the provision of care on these points.
About the investigation
The data used comes from Nivel Primary Care Registrations. The data relate to 346 general practices with 1,060,618 registered patients in 2019. The patients represent a representative reflection of the Dutch population in terms of age and gender. The number of patients, practices and years analyzed differs per indicator.
