Department of General Practice and Primary Health Care, University of Auckland , Auckland 1142, New Zealand.
Health Soc Care Community. 2010 May;18(3):296-303. doi: 10.1111/j.1365-2524.2009.00904.x. Epub 2010 Feb 7.
We have previously reported a preliminary taxonomy of patient error. However, approaches to managing patients' contribution to error have received little attention in the literature. This paper aims to assess how patients and primary care professionals perceive the relative importance of different patient errors as a threat to patient safety. It also attempts to suggest what these groups believe may be done to reduce the errors, and how. It addresses these aims through original research that extends the nominal group analysis used to generate the error taxonomy. Interviews were conducted with 11 purposively selected groups of patients and primary care professionals in Auckland, New Zealand, during late 2007. The total number of participants was 83, including 64 patients. Each group ranked the importance of possible patient errors identified through the nominal group exercise. Approaches to managing the most important errors were then discussed. There was considerable variation among the groups in the importance rankings of the errors. Our general inductive analysis of participants' suggestions revealed the content of four inter-related actions to manage patient error: Grow relationships; Enable patients and professionals to recognise and manage patient error; be Responsive to their shared capacity for change; and Motivate them to act together for patient safety. Cultivation of this GERM of safe care was suggested to benefit from 'individualised community care'. In this approach, primary care professionals individualise, in community spaces, population health messages about patient safety events. This approach may help to reduce patient error and the tension between personal and population health-care.
我们之前曾报告过初步的患者错误分类法。然而，在文献中，管理患者对错误的贡献的方法几乎没有受到关注。本文旨在评估患者和初级保健专业人员如何看待不同患者错误对患者安全的相对重要性。它还试图提出这些群体认为可以采取哪些措施来减少错误，以及如何减少错误。它通过扩展用于生成错误分类法的名义群体分析来进行这项研究。2007 年末，在新西兰奥克兰，对 11 组经过精心挑选的患者和初级保健专业人员进行了访谈。共有 83 名参与者，包括 64 名患者。每个组都对通过名义群体练习确定的可能患者错误的重要性进行了排名。然后讨论了管理最重要错误的方法。在错误的重要性排名上，各个群体之间存在很大差异。我们对参与者建议的一般归纳分析揭示了管理患者错误的四项相互关联的行动内容：建立关系；使患者和专业人员能够识别和管理患者错误；对他们共同的改变能力做出反应；并激励他们共同为患者安全而行动。建议培养这种安全护理的“危险根源”（Grow Relationships；Enable Patients and Professionals to Recognise and Manage Patient Error；be Responsive to their shared capacity for change；and Motivate them to act together for patient safety），以受益于“个体化社区护理”。在这种方法中，初级保健专业人员在社区空间中个性化地传达关于患者安全事件的人口健康信息。这种方法可能有助于减少患者错误和个人与人群健康护理之间的紧张关系。
