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Key priority areas for patient safety improvement strategy in Libya: a protocol for a modified Delphi study
  1. Mustafa Elmontsri,
  2. Ricky Banarsee,
  3. Azeem Majeed
  1. Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
  1. Correspondence to Mustafa Elmontsri; m.elmontsri10{at}


Introduction Patient safety is a global public health problem. Estimates and size of the problem of patient safety in low-income and developing countries are scarce. A systems approach is needed for ensuring that patients are protected from harm while receiving care. The primary objective of this study will be to use a consensus-based approach to identify the key priority areas for patient safety improvement in Libya as a developing country.

Design A modified Delphi study.

Methods and analysis A three-phase modified Delphi study will be conducted using an anonymous web-based questionnaires. 15 international experts in the field of patient safety will be recruited to prioritise areas of patient safety that are vital to developing countries such as Libya. The participants will be given the opportunity to rank a list of elements on five criteria. The participants will also be asked to list five barriers that they believe hinder the implementation of patient safety systems. Descriptive statistics will be used to evaluate consensus agreement, including percentage agreement and coefficient of variation. Kendall’s coefficient of concordance will be used to evaluate consensus across all participants.

Ethics and dissemination Ethical approval has been granted from Imperial College Research Ethics Committee (ICREC: 16IC3598). The findings of the study will be published in a PhD thesis. A manuscript will also be prepared for publication in a high-impact peer-reviewed journal describing the Delphi process and the findings of the study.

  • Patient safety
  • adverse events
  • Developing Countries
  • Delphi study
  • System Approach

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors ME and RB prepared the study design and the content of the study protocol. MA further improved the quality of the protocol with important intellectual revisions and assisted in the development of the survey questionnaire for round one. ME is responsible for drafting the protocol manuscript, which was then revised and approval by RB and MA.

  • Funding This study is part of ME's PhD research, which was funded by the Government of Libya. The Department of Primary Care and Public Health at Imperial College London is grateful for support from the NW London NIHR Collaboration for Leadership in Applied Health Research & Care (CLAHRC), the Imperial NIHR Biomedical Research Centre and the Imperial Centre for Patient Safety and Service Quality (CPSSQ).

  • Competing interests None declared.

  • Ethics approval Imperial College Research Ethics Committee ICREC: 16IC3598.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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