Medical safety and community practice: necessary elements and barriers to implement a safety learning system.

A safety learning system (SLS) is a system that monitors patient safety incident information and analyzes it to develop and implement improvement strategies to increase patient safety. The purpose of this paper is to discuss the necessary elements of a community-based family medicine practice SLS in Alberta Health Services - Calgary zone, and barriers to, and facilitators of, the implementation of this system. An SLS was developed in the research program Medical Safety in Community Practice. To determine the elements necessary to implement an SLS in community-based family medicine practice, we performed a comprehensive literature review, internal investigator discussions and internal investigator and external stakeholder reviews of key design elements. The system is currently being implemented and tested in community-based family practices as part of the program. Steps identified for implementation: included determining key design elements including creating a website and ascertaining a classification system or taxonomy; developing recruitment strategies; establishing an incident analysis methodology; building a knowledge translation strategy; and pursuing sustainability. These elements produced an SLS that is easily incorporated into community-based family medicine clinics.