April 2001 • Volume 7 • Number 4
FPs, GPs in six countries to go on lookout for medical errors this summer
Family doctors in other countries might have something to learn from U.S. family physicians about avoiding medical errors, and vice versa. That thought occurred to Susan Dovey while she worked on AAFP's study of medical errors in the United States last year.
Dovey was struck by the high percentage of filing errors the FPs reported, and she suspected the glitches would be fewer in other developed countries because of differences in filing systems. A native of New Zealand, Dovey is an analyst in the Robert Graham Center in Washington.
"It seemed strange to me that there were people in the United States employed to do nothing but filing, and there were rooms full of files -- as if there were no other way to do it," says Dovey.
Her hunch blossomed into the first international study of medical errors in primary care, now being launched in six countries.
"I think the way messages are handled is probably a problem across all countries, and maybe we can find out whether there is a better way or worse way of handling messages," says Dovey. "Also, it will be interesting to see whether certain types of clinical mistakes happen more in some countries than in others -- like whether wrong decisions about drugs are made more in one country than another."
The first phase of the three-part international study is just beginning in the United States, Canada, England, the Netherlands, New Zealand and Australia. The Robert Graham Center is coordinating phase one, which is supported in part by the Commonwealth Fund, known for its funding of health policy research and international fellowships. Dovey is principal investigator for the new study.
At least 20 FPs and GPs in each of the six countries will report on at least 10 errors they observe in their practices this summer. Key questions the physicians will answer include: What happened? What may have contributed to this error? What could have prevented it? Was any patient harmed? How often does this error occur in your practice?
The Institute of Medicine blew the whistle on U.S. medical errors in late 1999 in a report that dealt mainly with hospital errors because data on them were readily available.
The protocol for the international study accents the need for research in primary care: "Primary medical care is complex. ... Its diversity, breadth of scope, and variation in structure and infrastructure may offer more opportunity for error than hospital-based care, which tends to be more highly regulated and procedure-oriented."
The study's first phase will describe differences in types of errors recognized by primary care physicians in the six countries. Dovey hopes the phase one report will be published in the journal Health Affairs early next year.
Phases two and three are still on the drawing board. The second phase will share information about the international physicians' strategies to avert errors. The third phase will develop and test intervention strategies in international settings.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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