January 2001 • Volume 7 Number 1
Practice errors far more clerical than clinical
BY JANE STOEVER
In the first nationwide study of patient safety in primary care, family physicians have reported many more system errors than mistakes in medical judgment or treatment.
The 42 family physicians in the study reported things that should not have happened in their offices -- things the FPs hope will not happen again.
Based on a preliminary review of the data, the overwhelming majority of errors relate to:
- office management systems that don't prevent, for example, filing patient information in the wrong place or ordering the wrong tests, treatments and pharmaceuticals;
- poor communication with patients and with others in the practice or outside the practice; and
- payment problems, including those caused by referring a patient to a provider outside the patient's health plan.
"We don't have to think about how we can avoid chopping off the wrong leg," says Susan Dovey, M.P.H., principal investigator for the study. "Instead, we have to think about some more 'down home' things. And they're not trivial. About half the errors reported resulted in some adverse effect on patients."
Dovey presented preliminary results from the study during the annual meeting of the North American Primary Care Research Group Nov. 4-7 on Amelia Island, Fla. She serves on the staff of the Robert Graham Center, AAFP's policy center in Washington. The physician researchers, each of whom was asked to report 10 errors, belong to AAFP's National Network for Family Practice and Primary Care Research.
"Almost all the information about medical errors to date has been focused on hospitals," says Dovey. "This study is churning out exciting results that will add to the body of knowledge. Early intervention to remedy errors in primary care may avert patients' need for secondary care."
The study, which points to the need for more extensive research, is expected to be completed and published in 2001.
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