Reporting patient safety incidents in general practice

Abstract

OBJECTIVE: To gain insight into the frequency, severity, causes and consequences of potentially preventable patient-safety incidents in Dutch primary care. DESIGN: Retrospective medical record review study. METHOD: We screened a sample of 1000 medical records in 20 general practices and 1145 medical records with four out-of-hours general practitioner (GP) cooperatives. Potential incidents were evaluated by experienced GPs. RESULTS: A total of 9546 contacts with GPs were screened: 8401 contacts during office hours and 1145 in out-of-hours care. During the first phase of the medical record review, 260 and 56 potential incidents were found. After evaluation by experts,211 and 27 cases were deemed to be patient-safety incidents. This is an incidence rate of 2.5% (general practices) and 2.4% (out-of-hours GP cooperatives). Most of the incidents did not have any consequences for the patients concerned. We did not find any incidents that had resulted in permanent harm or death. CONCLUSION: Patient safety incidents do occur in primary care, but most do not have severe health outcomes for the patient. This has to be taken into account when assessing and improving patient safety in primary care.