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.
- 1. Dovey SM, Meyers DS, Phillips RL, et al. A preliminary taxonomy of medical errors in family practice. J Qual Safety Health Care 2002. In press.
- 2. Australian Medical Workforce Advisory Committee. The general practice workforce in Australia. AMWAC Report 2000.2. Sydney: AMWAC, 2000. Available at <http://amwac.health.nsw.gov.au/amwac/amwac/pdf/gp_2002.pdf>.
- 3. Western M, Dwan K, Makkai T, et al. Measuring IT use in Australian general practice 2001. Brisbane: University of Queensland, 2001.
- 4. General Practice Computing Group. Practice Incentive Payment Statistics: electronic data connectivity. <http://www.gpcg.org/topics/pip.html#connectivity>. Accessed 3 June 2002.
- 5. Foy R, Parry J, McAvoy B. Clinical trials in primary care: targeted payments for trials might help improve recruitment and quality. BMJ 1998; 317: 1168-1169.
- 6. Moore A. The ethics of payment for research participants. Monash Bioethics Rev 1996; 15(3): 10-13.
- 7. Bhasale AL, Miller GC, Reid SE, Britt HC. Analysing potential harm in Australian general practice: an incident monitoring study. Med J Aust. 1998; 169: 73-76. <MJA full text>
- 8. Britt H, Miller GC, Steven ID, et al. Collecting data on potentially harmful events: a method for monitoring incidents in general practice. Fam Pract 1997; 14: 101-106.
- 9. Bhasale A. The wrong diagnosis: identifying causes of potentially adverse events in general practice using incident monitoring. Fam Pract 1998; 15: 308-318.
- 10. Miller G, Britt H, Steven I, et al. Clinical Incident Monitoring. Aust Fam Physician 1996; 25: 821.
- 11. Leape LL. A systems analysis approach to medical error. J Eval Clin Pract 1997; 3: 213-222.
- 12. Kidd M, Veale B. How safe is Australian general practice and how can it be made safer? [editorial]. Med J Aust 1998; 169: 67-68. <MJA full text>
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.