• Patient Safety - Testing Process

    Estimating Rates and Describing Causes and Consequences of Testing Process Errors Detected in Family Physician Offices.

    Study Description and Methods

    This is an observational study that took place in four family practice offices and four family practice residency clinics. Data was collected using error reporting, focus groups, and re-design investigations. For the error reporting, physicians and staff submitted anonymous reports on things that happen in the practice related to laboratory and diagnostic imaging processes “that should not have happened and that you don’t want to happen again.” Participants submitted reports on the Internet to the AAFP Patient Safety Reports secure website or by written reports between April 2003 and November 2003. Participant focus groups were conducted at all eight research sites and re-design investigations were conducted at two sites. In addition, lead physician and study coordinator focus groups were convened at the AAFP National Network Research Convocation in March 2004.

    Specific Aims and Objectives

    1. To describe Testing Process Errors detected in family medicine practices by physicians and office staff and estimate rates of Testing Process Errors as reported during intensive one-week monitoring periods;
    2. To investigate causes and consequences of these errors; and
    3. To generate hypotheses about interventions to avert laboratory and imaging process errors in primary care practices, which we will test in subsequent studies.


    This study was funded from October 1, 2002 to September 30, 2005.


    This study has completed data collection and is currently closed. Please see a listing of our publications below.

    Key Findings and Publications

    It Takes Two: Using Co-Leaders to Champion Improvements in Small Primary Care Practices. Gallagher KM, Nutting PA, Nease DE, Graham DG, Bonham AJ, Dickinson WP, Main DS. The Journal of the American Board of Family Medicine. 2010; 23(5): 632-639.

    Quality and Safety in Outpatient Laboratory Testing.  Elder NC, Hickner JM, Graham DG. Clinics in Laboratory Medicine. 2008 28(2): 295-303.

    Testing Process Errors and Their Harms and Consequences Reported from Family Medicine: A Study of the AAFP National Research Network. Hickner JM, Graham DG, Elder NC, Brandt E, Emsermann C, Dovey S, Phillips R. Quality and Safety in Healthcare 2008 17:194-200.

    The Testing Process in Family Medicine: Problems, Solutions and Barriers as Seen by Physicians and Their Staff: A study of the American Academy of Family Physicians' National Research Network. Elder NC, Graham D, Brandt E, Dovey S, Phillips R, Ledwith J, Hickner J. Journal of Patient Safety (2006) 2 (1):25-32.

    Contact Information

    For additional information about this study, please contact:

    AAFP National Research Network
    1-800-274-2237 x3180

    This study is funded by grants from the Agency for Healthcare Research and Quality (AHRQ).