The Practice and Experience of Significant Event Audit in Primary Care
Grace Sweeney, Richard Westcott & Jonathan Stead
The aim of the study was to explore the use of SEA within primary care teams, and to identify the potential benefits afforded by the process in terms of team-building, professional development and service outcome. The project was funded by the Somerset & North Devon Education Purchasing Consortium
Study Design and Method
This was a longitudinal study, following a case study approach and using qualitative methods of data collection and analysis. Initially, we conducted preliminary interviews with twelve members of the primary care team. These individuals included practice managers, general practitioners, practice nurses, receptionists and community staff, and were recruited from three separate practices where SEA had been established as a regular activity. Following completion of the preliminary interviews, two practices were recruited for the purposes of more detailed examination of the implementation and development of SEA. Both of these practices were selected as they were in the process of developing SEA as a regular event in practice life. Data was collected at each of the two primary care sites by (1) observing six consecutive SEA meetings, and (2) interviewing a sample of the multidisciplinary team prior to and following the observed SEA meetings. Each of the SEA meetings were observed by the same researcher, who assumed the role of a non-participant observer, and who kept a written record of the proceedings. These field notes were supplemented by official agendas and minutes arising from each meeting. Data arising from the observation arm of the study was subject to a content analysis. Pre-SEA and post-SEA interviews were semi-structured, tape-recorded and subjected to a grounded theory analysis.
At the end of data collection and data analysis, a 'negotiated feedback session' was convened in both primary care practices, so that findings of the study could be shared with and verified by, study participants.
This study has now been completed. The findings of the preliminary interviews have been published as a separate piece of work (Westcott, Sweeney, & Stead, 2000), and each of the case studies are in the process of being prepared for publication. The following points can be distilled from the combined findings of the case study practices;
The use of SEA in primary care was generally viewed as a positive development by all members of the team. There was evidence from both practices that the identification of items through the process of SEA lead to swift and positive change in practice life. In addition there was seen to be a considerable improvement in team relations and in the general ethos of the participating practices.