Error and safety in primary care: no clear boundaries

Abstract

This paper examines the notions of adverse events, error, critical incidents and safety from the specific viewpoint of primary care. We conclude that each term can be defined, but existing work which we reviewed uses many of the terms interchangeably. We recognise that trying to access medical error objectively within primary care can be problematic. Regardless of definitions, reflection on critical incidents, adverse events or other notable events is important, but requires time and resources to be conducted effectively.

"Every error counts": a web-based incident reporting and learning system for general practice

“…In the primary care setting, the discrimination between error and non-error sometimes presents difficulties 20. Hence, we used a simple definition of incidents that could easily be understood and remembered and would therefore not present a hindrance to reporting.…”

Patient safety and general practice: traversing the tightrope

“…9 This sounds deceptively simple. However, protected time is subject to political vagaries and comes at an opportunity cost meaning other competing service priorities may be forsaken; while time allocation decisions of this sort are not always under the full control of many clinicians.…”

Awareness and analysis of a significant event by general practitioners: a cross sectional survey

“…Indeed, the important issue of why an event is deemed ''significant'' enough to be identified for analysis (or not) requires in depth study. 21 More evidence is also required to gain a better understanding of these and other factors if SEA is to be established as a worthwhile and effective technique. A major difficulty in doing this is the complexity and uncertainty that characterises much of day to day general practice, making it a difficult area to research adequately and leaving many relevant questions unanswered.…”

“…For example, the terms ''adverse event'', ''critical incident'', ''error'', ''near miss'', and ''significant event'' appear to be used arbitrarily and interchangeably in relation to risk and safety issues in primary care. 21 We conducted an exploratory survey to determine the professional and practice characteristics of a group of GPs who reported being aware of a recent significant event associated with their practice. We aimed to assess whether a structured analysis of this specific event was undertaken and whether this impacted on the perceived risk of the event recurring.…”