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The Identification of Medical Errors by Family Physicians During Outpatient Visits

Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio

CORRESPONDING AUTHOR: Nancy C. Elder, MD, MSPH, Department of Family Medicine, University of Cincinnati, PO Box 670582, Cincinnati, OH 45267-0582, eldernc{at}fammed.uc.edu

BACKGROUND We wanted to describe errors and preventable adverse events identified by family physicians during the office-based clinical encounter and to determine the physicians’ perception of patient harm resulting from these events.

METHOD We sampled Cincinnati area family physicians representing different practice locations and demographics. After each clinical encounter, physicians completed a form identifying process errors and preventable adverse events. Brief interviews were held with physicians to ascertain their perceptions of harm or potential harm to the patient.

RESULTS Fifteen physicians in 7 practices completed forms for 351 outpatient visits. Errors and preventable adverse events were identified in 24% of these visits. There was wide variation in how often individual physicians identified errors (3% to 60% of visits). Office administration errors were most frequently noted. Harm was believe to have occurred as a result of 24% of the errors, and was a potential in another 70%. Although most harm was believed to be minor, there was disagreement as to whether to include emotional discomfort and wasted time as patient harm.

CONCLUSIONS Family physicians identify errors and preventable adverse events frequently during patient visits, but there is variation in how some error categories are interpreted and how harm is defined.

Key Words: Medical errors • diagnostic errors • medication errors • patient safety • delivery of health care • health services research

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