Aim:
People from culturally and linguistically diverse (CALD) backgrounds are at higher risk of experiencing patient safety events in their healthcare. Evidence of the safety of cancer care for CALD communities is however lacking. This study aimed to determine the frequency and nature of safety events for people from CALD backgrounds accessing cancer services in Australia.
Methods:
A two-stage retrospective medical record review was conducted using an adapted Oncology Trigger Tool at four cancer services, two each in New South Wales (NSW) and Victoria (VIC). Based on the sample size requirements, patient records of those from CALD backgrounds were identified based on administrative data of country of birth, language spoken at home, preferred language and interpreter required. In first stage, data extraction tool was used to collect administrative and safety event data by two researchers at each service. In second stage, service-specific cancer clinician reviewed the data collected for further validation/exclusion. Data analysis was conducted using SPSS software.
Results:
A total of 640 patient records were reviewed across four cancer services of which 215 records (33.6%) had at least one safety event in a 12-month follow up period, with almost 15% (95/640) of records reporting two or more safety events. A total of 423 safety events were identified from the 215 patient records. Most safety events occurred in inpatient setting (328/423, 77.5%), with medication related safety events (127/423, 30%) most frequently documented followed by safety events in clinical processes e.g. skin breakdown or development of pressure sore (76-423, 18%).
Implications:
Patient safety events in Australian cancer services occur among consumers from CALD backgrounds at approximately three times the rate of safety events in the general population. Strategies to create shared understanding of instructions relating to medication management and care processes between clinicians and consumers may contribute to addressing this inequity in safety outcomes.