Makeham Meredith A B, Dovey Susan M, County Mary, Kidd Michael R
Department of General Practice, University of Sydney, 37a Booth Street, Balmain, NSW 2041, Australia.
Med J Aust. 2002 Jul 15;177(2):68-72. doi: 10.5694/j.1326-5377.2002.tb04668.x.
To develop an international taxonomy describing errors reported by general practitioners in Australia and five other countries.
GPs in Australia, Canada, the Netherlands, New Zealand, the United Kingdom and the United States reported errors in an observational pilot study. Anonymous reports were electronically transferred to a central database. Data were analysed by Australian and international investigators.
Non-randomly selected GPs: 23 in Australia, and between 8 and 20 in the other participating countries.
Error categories, and consequences.
In Australia, 17 doctors reported 134 errors, compared with 301 reports by 63 doctors in the other five countries. The final taxonomy was a five-level system encompassing 171 error types. The first-level classification was "process errors" and "knowledge and skills errors". The proportion of errors in each of these primary groups was similar in Australia (79% process; 21% knowledge and skills) and the other countries (80% process; 20% knowledge and skills). Patient harm was reported in 32% of reports from Australia and 30% from other countries. Participants considered the harm "very serious" in 9% of Australian reports and 3% of other countries' reports.
This pilot study indicates that errors are likely to affect primary care patients in similar ways in countries with similar primary healthcare systems. Further comparative studies are required to improve our understanding of general practice error differences between Australia and other countries.
制定一种国际分类法,用于描述澳大利亚及其他五个国家的全科医生报告的医疗差错。
澳大利亚、加拿大、荷兰、新西兰、英国和美国的全科医生在一项观察性试点研究中报告医疗差错。匿名报告通过电子方式传输至中央数据库。数据由澳大利亚和国际研究人员进行分析。
非随机选择的全科医生:澳大利亚23名,其他参与国家8至20名。
差错类别及后果。
在澳大利亚,17名医生报告了134起差错,而其他五个国家的63名医生报告了301起差错。最终的分类法是一个五级系统,包含171种差错类型。一级分类为“流程差错”和“知识与技能差错”。在澳大利亚(流程差错占79%;知识与技能差错占21%)和其他国家(流程差错占80%;知识与技能差错占20%),这些主要类别中每种差错的比例相似。澳大利亚32%的报告和其他国家30%的报告中提到了患者受到伤害。在澳大利亚9%的报告和其他国家3%的报告中,参与者认为伤害“非常严重”。
这项试点研究表明,在拥有相似初级医疗保健系统的国家,医疗差错可能以相似的方式影响初级保健患者。需要进一步开展比较研究,以增进我们对澳大利亚与其他国家全科医疗差错差异的理解。