Abstract
BackgroundPatient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to show areas where potential improvements could be implemented.MethodsWe conducted a retrospective review of patient records in Dutch general practice. A random sample of 1,000 patients from 20 general practices was obtained. The number of patient safety incidents that occurred in a one-year period, their perceived underlying causes, and impact on patients' health were recorded.ResultsWe identified 211 patient safety incidents across a period of one year (95% CI: 185 until 241). A variety of types of incidents, perceived causes and consequences were found. A total of 58 patient safety incidents affected patients; seven were associated with hospital admission; none resulted in permanent disability or death.ConclusionsAlthough this large audit of medical records in general practices identified many patient safety incidents, only a few had a major impact on patients' health. Improving patient safety in this low-risk environment poses specific challenges, given the high numbers of patients and contacts in general practice.
Highlights
Patient safety can be at stake in both hospital and general practice settings
Study design and setting A retrospective medical record review study of 1,000 patients was undertaken to investigate the prevalence of patient safety incidents in general practice in the Netherlands
Data analyses We described the patient safety incidents detected in terms of type of event, perceived causes of the event (Prevention and Recovery Information System for Monitoring and Analysis: PRISMA method) [17], actual harm caused [18], and probability of severe harm
Summary
Patient safety can be at stake in both hospital and general practice settings. Another study showed 100 incident reports by healthcare workers in a one year period (with 25,000 visits) in an ambulatory care setting [10]. A prevalence of 5 to 80 adverse events in ambulatory care per 100,000 consultations has been estimated [11] Incident reporting by health professionals has not been found to provide valid estimates of the prevalence within a defined setting [8]. Large-scale quantitative studies of patient safety incidents, using random samples of patient records, have only been conducted in hospital settings [12].
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