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July/August 2004 Annals of Family Medicine tip sheet

Medical Errors in Primary Care: A Breakdown in Relationships and Access
Counter to the prevailing perception that adverse drug events and surgical mishaps are the primary causes of medical errors, this qualitative study of 38 patients suggests that breakdowns in the clinician-patient relationship (37 percent) and access to clinicians (29 percent) may be more prominent. When asked about problems they experienced in the primary care office setting, patients were more likely to report being harmed psychologically and emotionally (70 percent) than physically (23 percent), suggesting that the current preoccupation of the patient safety movement could overlook other patient priorities. The authors posit that although systems changes might ameliorate some of the errors patients report, they do not directly address the rushed, dehumanizing health care experiences identified by the patients who participated in this study.
Patient Reports of Preventable Problems and Harms in Primary Health Care
By Anton J. Kuzel, M.D., M.H.P.E., et al

Studying Medical Errors as a String of Mistakes Sheds Light on Root Cause, Often Miscommunication
While much of the patient safety movement has focused on the medical errors that are easiest to recognize and remedy, including adverse drug events and surgical mishaps, many diagnostic and treatment errors may actually begin with errors in communication. By studying medical errors as a chain of events, Woolf and colleagues find that two out of every three mistakes in treatment and diagnosis were set into motion by errors in communication. In a study of error reports from 18 primary care offices in six different countries, the researchers found that a chain of errors occurred in 77 percent of the reported incidents. Fully 80 percent of those errors involved personal or informational miscommunication. Examples of informational miscommunication included communication breakdowns among colleagu
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Contact: Angela Lower
alower@aafp.org
913-906-6253
American Academy of Family Physicians
28-Jul-2004


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