Avoiding and fixing medical errors in general practice: Prevention strategies reported in the Linnaeus Collaboration's Primary Care International Study of Medical Errors

Murray Tilyard, Susan Dovey and Katherine Hall

OBJECTIVE: To report tactics for avoiding and remedying medical errors observed by general practitioners in New Zealand and five other countries. METHODS: The Primary Care International Study of Medical Errors collected 66 reports of medical errors in New Zealand and 363 reports from general practitioners in Australia, Canada, England, the Netherlands, and the United States. Strategies for avoiding and overcoming errors were grouped by themes, for New Zealand and the five other countries combined. RESULTS: In all New Zealand reports and 336 (92.6%) reports from other countries, doctors offered at least one error prevention idea. The largest category of suggestions was ‘more diligence’ (New Zealand: 69.7% of reports, other countries: 55.3%). Other strategies were: ‘provide care differently’ (New Zealand 22.7%, other countries 36.4%); ‘improve communication’ (19.7% and 17.8% of reports); ‘education’ (7.8% and 11.0% of reports); and ‘more resources’ (12.1% and 14.0% of reports). CONCLUSIONS: In general practitioners’ medical errors reports, a culture of individual blame is more evident than recognized need for systems design. A minority of reports contained specific, pragmatic suggestions for changing health care systems to protect patients’ safety. Error reporting systems may be a practical way to generate innovative solutions to potentially harmful problems facing general practice patients.

Tilyard M, Dovey S, Hall K. Avoiding and fixing medical errors in general practice: Prevention strategies reported in the Linnaeus collaboration's primary care international study of medical errors. N Z Med J. 2005; 118(1208).