Patient safety in mental health - Canadian Patient Safety Institute ...

Key Informant Interviews
Background
Persons with expertise in patient safety in mental health
are a source of information on current practices, upcoming
initiatives, and issues that may not be available in
white or grey literature. Forming the basis of the second
research methodology, 19 interviews were carried out
with Canadian and international leaders and stakeholders
in the areas of patient safety and/or mental health.
Method
Interviewees were selected by the Advisory Committee,
OHA, and CPSI, and identified as candidates because
of their knowledge and expertise in patient safety and/or
mental health. The majority of the key informants interviewed
were from Canada (78.9%). Four international
experts were interviewed: one from Australia, one from
the United Kingdom, and two from the United States.
Canadian key informants were drawn from different regions
across Canada (see Table 1) 2 . Twelve interviewees
held management or administrative positions, nine held
academic positions, seven held clinical positions, five
worked as advisors or consultants, three held leadership
positions with a national patient safety organization, and
two were identified as patient advocates (See Table 1).
One interview participant was a judge with experience
in forensic mental health and another worked in health
insurance as a risk assessor.
2 It is noted that seven participants were national representatives;
two from Alberta and five from Ontario. However, only two adopted
a national perspective, either because what they said was not location
specific or they made numerous mention to Canadian-wide issues.
2
All interviews were carried out over the phone by a single
interviewer. The interviews were qualitative, structured interviews
and designed to seek information on current initiatives
and research; strategies for improving patient safety;
emerging issues; gaps in current knowledge and practice;
and barriers to improving patient safety. See Appendix D
for a copy of the interview guide. The interviews ranged
in length from 30 to 75 minutes. All interviews were audio
recorded and transcribed. Prior to each interview, the
interview guide was sent to the interviewee to allow them
time to familiarize themselves with the questions. At the
beginning of each interview, interviewees were assured of
the anonymity of their responses and verbal consent was
sought to continue with and record the interview.
Analysis
Table 1—Key Informant’s Region and Work Place Setting.
The analysis involved a two-step process. The first step
involved coding each interview on issues that were easily
categorized and that could provide some basic quantitative
data, such as how often a particular adverse event
was mentioned. This process assists in organizing the interview
data in a more easily manageable and accessible
format. During the second step, larger themes emerging
from the data were identified. These themes were not
restricted to responses to individual interview questions
and often spanned a variety of questions. Themes were
identified, in part, through the initial coding and categorization
process as well as by reading and re-reading the
interview transcripts.
Location Frequency (%) Workplace Setting Frequency (%)a
Canada 1 % Academia %
• BC 1 % Clinical 3 %
• Alberta 2 11% Patient Safety 3 1 %
• Ontario % Patient Advocacy 2 11%
• Quebec 1 % Advisor/Consultant 2 %
• Nova Scotia 2 11% Management/Administration 12 3%
Australia 1 % Legal/Risk Management 2 11%
United Kingdom 1 %
United States 2 11%
Total Number of Interview Participants N = 1
a Some interviewees held more than one position.