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BMJ Qual Saf 20:1005-1010 doi:10.1136/bmjqs-2011-000105
  • Original research

Safety incidents in family medicine

  1. Peter G Norton1
  1. 1Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
  2. 2Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Maeve O'Beirne, W21C Research Centre, G-01 TRW Building, 3280 Hospital Drive NW, Calgary AB T2N 4Z6, Canada; obeirne{at}ucalgary.ca
  • Accepted 30 July 2011
  • Published Online First 5 September 2011

Abstract

Objective To discuss the characteristics of incidents reported to the Medical Safety in Community Practice (MSCP) safety learning system.

Methods Members of family physician offices in the Alberta Health Services—Calgary zone, confidentially reported patient safety incidents via web or fax from September 2007 to August 2010. The incident reporting form contained both open-ended and closed questions. Incidents were reviewed for their characteristics.

Results A total of 19 family practices participated in MSCP. A total of 264 useable reports were collected. Reporting was higher when practices first joined and then decreased. There was an average of 1.4 reports per month. Physicians submitted the majority of reports. Physicians and nurses were more likely to report an incident than office staff. The vast majority of reported incidents were judged to have virtually certain evidence of preventability’ (93%). Harm was associated with 50% of incidents. Only 1% of the incidents had a severe impact. The top four types of incidents reported were documentation (41.4%), medication (29.7%), clinical administration (18.7%) and clinical process (17.5%).

Conclusion MSCP has developed and implemented the first safety learning system in Canada for family practice. All clinic members were encouraged to submit reports, but most of the incidents were reported by physicians. The vast majority of incidents reported were preventable with limited severity. The most frequently reported types of incidents fell into the categories of documentation and medication. The low reporting rates suggest that for family practices incident reporting may not be the most effective method to determine the types and frequency of incidents in family medicine.

Footnotes

  • Funding This project is funded by Alberta Heritage Foundation for Medical Research, Canadian Health Services Research Foundation and Canadian Patient Safety Institute.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by University of Calgary.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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