RT Journal Article
SR Electronic
T1 Patient Error: A Preliminary Taxonomy
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 223
OP 231
DO 10.1370/afm.941
VO 7
IS 3
A1 Stephen Buetow
A1 Liz Kiata
A1 Tess Liew
A1 Tim Kenealy
A1 Susan Dovey
A1 Glyn Elwyn
YR 2009
UL http://www.annfammed.org/content/7/3/223.abstract
AB PURPOSE Current research on errors in health care focuses almost exclusively on system and clinician error. It tends to exclude how patients may create errors that influence their health. We aimed to identify the types of errors that patients can contribute and help manage, especially in primary care. METHODS Eleven nominal group interviews of patients and primary health care professionals were held in Auckland, New Zealand, during late 2007. Group members reported and helped to classify types of potential error by patients. We synthesized the ideas that emerged from the nominal groups into a taxonomy of patient error. RESULTS Our taxonomy is a 3-level system encompassing 70 potential types of patient error. The first level classifies 8 categories of error into 2 main groups: action errors and mental errors. The action errors, which result in part or whole from patient behavior, are attendance errors, assertion errors, and adherence errors. The mental errors, which are errors in patient thought processes, comprise memory errors, mindfulness errors, misjudgments, and—more distally—knowledge deficits and attitudes not conducive to health. CONCLUSION The taxonomy is an early attempt to understand and recognize how patients may err and what clinicians should aim to influence so they can help patients act safely. This approach begins to balance perspectives on error but requires further research. There is a need to move beyond seeing patient, clinician, and system errors as separate categories of error. An important next step may be research that attempts to understand how patients, clinicians, and systems interact to cocreate and reduce errors.