https://www.um.edu.mt/library/oar/handle/123456789/149110 2026-10-09T08:32:03Z 2026-10-09T08:32:03Z https://www.um.edu.mt/library/oar/handle/123456789/149588 2026-10-01T11:45:38Z 2026-01-01T00:00:00Z

Title: Introducing national quality and patient safety indicators for acute care hospitals : a stakeholder-based approach Abstract: Background: Healthcare organisations must deliver safe, effective, and person-centred care consistently. Measuring quality and safety is essential for monitoring performance, preventing harm, identifying errors, and supporting continuous improvement. Quality and patient safety indicators are needed to generate data that support governance processes and drive quality assurance and improvement initiatives by hospitals. Aim: To develop indicators to support the licensing and monitoring of the quality of care in acute care hospitals in Malta. It also aimed to evaluate the feasibility of implementing such indicators. Methodology: A mixed-method, exploratory sequential design was employed. A structured, purposive sampling approach was employed to recruit participants. A focus group was conducted with policymakers. The RAND/UCLA Appropriateness Method was used to set the indicators. This comprised an online questionnaire with key stakeholders for the first rating of indicators and a consensus meeting for the second-round rating of indicators. Each indicator was evaluated against three criteria: ‘Relevance/Appropriateness,’ ‘Validity and Reliability,’ and ‘Feasibility.’ Information about factors affecting the implementation of indicators from the different methods was triangulated. Results: The preliminary set of indicators was identified from the literature. The final 92 indicators were mapped into a conceptual framework comprising five quality dimensions and three domains. Most indicators were mapped to the structure and process domains, while the outcome domain included the Patient-Reported Experience Measures (PREMs). Indicators related to domains of safety and effectiveness were rated highly prioritised, reflecting participants’ familiarity with clinically oriented, evidence-based practices and the presence of supporting mechanisms. In contrast, indicators addressing the domains related to human factors and system-level patient safety, particularly responsive governance and person-centred care, were less prioritised and often rated uncertain or low potential. Feasibility received the lowest scores overall, highlighting gaps in safety governance and significant systemic weaknesses that hinder the implementation of these indicators. Conclusions and recommendations: This research identified quality and patient safety indicators for acute care hospitals. Recommendations were made for the implementation of these indicators. Description: M.Sc.(Melit.)

2026-01-01T00:00:00Z