Exploring quality and patient safety competencies and competency frameworks: A scoping review
Dimuthu Rathnayake, Sahar Hammoud, Veronica Hanlon, Louise Hendrick, Mary Browne, Gemma Moore, John Fitzsimons, Aoife De BrunAbstract
Background
Sustaining quality and patient safety (QPS) is a global priority due to risks such as patient harm, poor experiences, inequity, and resource waste. Training and education in key competency areas can support continuous improvement and enhance workforce performance. Clearly defining core QPS competencies for healthcare staff is essential to ensure preparedness to provide quality, safe care. Competency frameworks provide structured support for training and curriculum development, with many developed globally as strategic initiatives, some using evidence-based approaches. However, there is no consensus on core competencies to promote quality and patient safety, definitions of relevant terms can vary, and evidence on framework effectiveness is mixed. To address this research gap, the objective of this review was to systematically explore and collate evidence to provide insight into the current landscape of QPS competencies and frameworks. Additionally, this review sought to identify how competencies and competency frameworks have been designed, developed, implemented and evaluated.
Methods
We searched for studies on QPS competencies and frameworks in PubMed, CINAHL, Web of Science, PsycINFO, and Cochrane Library from Jan 2010 to April 2023. We also conducted grey literature searches on Google Scholar, Opengrey, and the National Institute for Health and Clinical Excellence (NICE). All studies that described QPS competencies and/or frameworks were included. Since the studies varied in type, a narrative approach was adopted to synthesise the included studies.
Results
Out of the initial 14,144 studies found, 118 were deemed relevant after thoroughly reviewing abstracts and full texts. Of these, 36 studies outlined specific QPS competency frameworks, while the remaining 82 studies assessed various QPS competencies across diverse contexts. Upon analysing data from all 118 studies, we identified 37 QPS topic areas and a variety of competency statements encompassing skills, knowledge, and behaviours deemed relevant for promoting QPS. The most frequent QPS topic areas included communication, patient safety culture, teamwork and collaboration, risk monitoring and management and patient-centred care.
Conclusion
The review has highlighted key insights into education and training related to QPS competencies. Core competency topic areas have been identified that are essential for workforce development and the promotion of quality and patient safety in healthcare settings. However, there is a gap in research on strategies to effectively implement and integrate QPS frameworks into practice, leading to insufficient evidence on translating these competencies into real-world application.