[Clinical error and adverse events: Primary care doctors perception].

OBJECTIVE

To evaluate how primary care physicians perceive and face clinical errors (CE) and/or adverse events (AE).

DESIGN

Cross-sectional study (personal mail survey). SETTING. Primary care physicians from "Ambit Costa de Ponent."

PARTICIPANTS

All doctors with tenure from this area (717).

MAIN MEASUREMENTS

Standardized questionnaire with error and adverse event frequencies. We compared answers considering age, gender, family medicine residency, "deniers" (never make a mistake), "perceptive" (admitting a mistake in the last year), "hyper-perceptive" (28 or more errors/adverse events a year), "internal locus of control" (admitting personal reasons in errors), and "hypersecure" (>7 points out of 10 in clinical security on Likert scale).

RESULTS

Two hundred thirty eight physicians (33.2%) with an average age of 42.6 (95% CI, 41.6-43.6) replied. The 28% were "deniers" (95% CI, 22.34-34.26), 67% "perceptive" (95% CI, 60.79-73.23), 7.4% "hyperperceptive" (95% CI, 4.41-11.44), 6% had "internal locus of control" (95% CI, 3.34-9.91), and 23.4% were "hypersecure" (95% CI, 18.14-29.22). Every doctor had on average 10.6 adverse events yearly, mainly drug side-effects (37%) (95% CI, 35.36-39.15), and diagnostic delay in oncology scenarios (33%) (95% CI, 31.16-34.85). The most common reaction to an error was to try and contact the patient (80%) (95% CI, 73.24-85.73) and to communicate the case to the team (41.4%) (95% CI, 33.97-49.22).

CONCLUSIONS

AE and CE were recognized as frequent, but a third of doctors affirmed they never made a mistake. Young male physicians, unlike senior ones, communicate mistakes to the team. "Internal locus of control" and "hyperperceptive" professionals tended to have stronger emotional reactions after committing errors. Physicians felt less secure with ophthalmology and ENT problems; and older doctors added to these dermatology and palliative care.