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Annals of Family Medicine 2:333-340 (2004)
© 2004 Annals of Family Medicine, Inc.
doi: 10.1370/afm.220
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Patient Reports of Preventable Problems and Harms in Primary Health Care

Anton J. Kuzel, MD, MHPE1, Steven H. Woolf, MD, MPH1, Valerie J. Gilchrist, MD2, John D. Engel, PhD2, Thomas A. LaVeist, PhD3, Charles Vincent, PhD4 and Richard M. Frankel, PhD5

1 Department of Family Medicine, Virginia Commonwealth University, Richmond, Va
2 Northeastern Ohio Universities College of Medicine, Rootstown, Ohio
3 Department of Health Policy and Management, Johns Hopkins University, Baltimore, Md
4 Imperial College of Science, Technology, and Medicine, St. Mary’s Hospital, London, England
5 Regenstreif Institute, Indiana University, Indianapolis, Ind


Figure 1
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  		Figure 1. Problems throughout the process of care.

* Typology codes:

  1. Access breakdown, difficulty contacting office, involving telephone system, telephone not answered, and excessive time on hold.
  2. Relationship breakdown, intermediary imposed on communication with clinician; and access breakdown, no return of telephone call.
  3. Relationship breakdown, disrespect or insensitivity, evident in interpersonal communication, rude behavior.
  4. Inefficiency of care, duplicative registration.
  5. Access breakdown, excessive office waiting time.
  6. Relationship breakdown, disrespect or insensitivity, evident in patient flow in the office, prioritizing patients based on race.
  7. Relationship breakdown, inadequate time with provider.
  8. Technical error, deficiency in history, incomplete history of medications.
  9. Relationship breakdown, disrespect or insensitivity, evident in interpersonal communication, patient advice ignored.
  10. Technical error, deficiency in treatment or follow-up, results of investigations not shared with patient.
  11. Relationship breakdown, disrespect or insensitivity, evident in interpersonal communication, patient preferences not respected.

 




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