Analysing potential harm in Australian general practice : an incident-monitoring study

摘要: OBJECTIVE: To collect data on incidents of potential or actual harm to general practice patients and evaluate the possible causes these incidents. DESIGN: An observational study based a modified critical technique. A non-random sample practitioners (GPs) anonymously submitted incident reports contemporaneously. SETTING AND PARTICIPANTS: Australian practices between October 1993 June 1995. During period, 324 GPs participated at some time. MAIN OUTCOME MEASURES: GP-reported free-text descriptions structured responses for preventability, harm, immediate consequences, predicted long-term outcomes, type incident, contributing factors, mitigating additional resource use. RESULTS: 805 were reported--76% preventable; 27% had severe harm. No long term was 66% Incidents could relate pharmacological management (51 per 100 incidents), nonpharmacological (42 diagnosis (34 incidents) equipment (5 incidents). The most common contributory factors poor communication healthcare professionals actions others (23 each) errors in judgement (22 CONCLUSION: Human error preventable system problems identified. monitoring technique provided useful which be applied prevention strategies.