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An international taxonomy for errors in general practice: a pilot study

Meredith A B Makeham, Mary County, Michael R Kidd and Susan M Dovey
Med J Aust 2002; 177 (2): 68-72.

Summary

Objectives: To develop an international taxonomy describing errors reported by general practitioners in Australia and five other countries.

Design and setting: GPs in Australia, Canada, the Netherlands, New Zealand, the United Kingdom and the United States reported errors in an observational pilot study. Anonymous reports were electronically transferred to a central database. Data were analysed by Australian and international investigators.

Participants: Non-randomly selected GPs: 23 in Australia, and between 8 and 20 in the other participating countries.

Main outcome measures: Error categories, and consequences.

Results: In Australia, 17 doctors reported 134 errors, compared with 301 reports by 63 doctors in the other five countries. The final taxonomy was a five-level system encompassing 171 error types. The first-level classification was "process errors" and "knowledge and skills errors". The proportion of errors in each of these primary groups was similar in Australia (79% process; 21% knowledge and skills) and the other countries (80% process; 20% knowledge and skills). Patient harm was reported in 32% of reports from Australia and 30% from other countries. Participants considered the harm "very serious" in 9% of Australian reports and 3% of other countries' reports.

Conclusions: This pilot study indicates that errors are likely to affect primary care patients in similar ways in countries with similar primary healthcare systems. Further comparative studies are required to improve our understanding of general practice error differences between Australia and other countries.

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  • Meredith A B Makeham1
  • Mary County2
  • Michael R Kidd3
  • Susan M Dovey4

  • 1 Department of General Practice, University of Sydney, Sydney, NSW.
  • 2 The Robert Graham Center: Policy Studies in Family Practice and Primary Care, American Academy of Family Physicians, Washington, DC, USA.

Correspondence: makeham@ozemail.com.au

Acknowledgements: 

We gratefully acknowledge the GP participants from the six countries. We would like to thank Walter Rosser, Aneez Esmail, Katherine Hall, Chris Van Weel, Anton Kuzel, Steven Woolf, and the other research members of the LINNAEUS collaboration. We also thank the World Health Network, Professor Charles Bridges-Webb AO of the NSW Projects, Research and Development Unit, RACGP, and Dr Jonathon Craig, Department of Public Health, University of Sydney, for their assistance.

Competing interests:

None identified.

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