Patient safety practices in an innovative digital landscape: an interview study on triage in Swedish digital primary care

TL;DR

This study explores how healthcare professionals ensure patient safety during triage in digital primary care, highlighting challenges and strategies in a rapidly evolving digital healthcare landscape.

Contribution

The study provides new insights into how healthcare professionals manage patient safety in digital triage systems through inductive analysis of interviews.

Findings

Healthcare professionals act as a fine-tuned instrument to avoid mistriage in digital triage systems.

Technical and organisational disruptions are resolved to maintain triage efficiency and safety.

Digital triage tools require professionals to interpret system outputs and manage broader care complexities.

Abstract

With rapid technological development and new triage systems in primary healthcare, care complexity is increasing, reshaping the landscape of patient safety. Despite their growing integration, little is known about how healthcare professionals safeguard patient safety during triage. Therefore, this study aimed to explore how healthcare professionals manage patient safety during the triage process in digital primary care.

An inductive and explorative research design was employed, using qualitative content analysis to analyse interviews with ten participants. The participants were healthcare professionals experienced with various triage systems.

Three themes were identified: acting as a fine-tuned instrument to avoid mistriage, resolving technical interruptions to prevent triage delays, and mitigating organisational disruptions to ensure adequate assessment. These themes reflected the participants’ continuous problem-solving efforts to maintain patient safety throughout the triage process.

The findings suggest that triage systems may be overly simplified, shifting greater responsibility to healthcare professionals, who must interpret system outputs and manage the broader complexities of primary care triage. We argue that triage safety emerges from the interaction between an understanding of the healthcare system’s contextual capacity, broad medical knowledge, and the interpersonal skills needed to recognise and respond to each patient’s unique situation.

Clinically, it is essential to define in advance the boundaries and procedures of the triage process, the mode of digital integration, and the system’s intended purpose. Specifying these elements helps ensure that the digital tool supports rather than complicates clinical work and helps establish the preconditions necessary for patient safety.