The Threats to Australian Patient Safety (TAPS) study: incidence of reported errors in general practice

Abstract

Objective: To determine the incidence of errors anonymously reported by general practitioners in NSW. Design: The Threats to Australian Patient Safety (TAPS) study used anonymous reporting of errors by GPs via a secure web‐based questionnaire for 12 months from October 2003. Setting: General practices in NSW from three groupings: major urban centres (RRMA 1), large regional areas (RRMA 2–3), and rural and remote areas (RRMA 4–7). Participants: 84 GPs from a stratified random sample of the population of 4666 NSW GPs — 41 (49%) from RRMA 1, 22 (26%) from RRMA 2–3, and 21 (25%) from RRMA 4–7. Participants were representative of the GP source population of 4666 doctors in NSW (Medicare items billed, participant age and sex). Main outcome measures: Total number of error reports and incidence of reported errors per Medicare patient encounter item and per patient seen per year. Results: 84 GPs submitted 418 error reports, claimed 490 864 Medicare patient encounter items, and saw 166 569 individual patients over 12 months. The incidence of reported error per Medicare patient encounter item per year was 0.078% (95% CI, 0.076%–0.080%). The incidence of reported errors per patient seen per year was 0.240% (95% CI, 0.235%–0.245%). No significant difference was seen in error reporting frequency between RRMA groupings. Conclusions: This is the first study describing the incidence of GP‐reported errors in a representative sample. When an anonymous reporting system is provided, about one error is reported for every 1000 Medicare items related to patient encounters billed, and about two errors are reported for every 1000 individual patients seen by a GP.

How safe is primary care? A systematic review

“…For example, a systematic review found that retrospective studies yielded a lower estimate of adverse drug events (3%),69 compared with prospective evaluations (10%) 70. Therefore, as with the overall rate of safety incidents, it is not possible to draw firm conclusions about the rate of consultations or people who experience diagnosis, communication or medication incidents, but we can say that these three broad categories made up the bulk of incidents recorded.…”

Patient safety events reported in general practice: a taxonomy

“…The reporting GPs demonstrated a clear understanding of the definition of error used 20. Investigators found less than 1% of reports to contain no safety event.…”

“…It has not been published in the peer-reviewed literature in full, however it can be viewed online 23. The TAPS electronic reporting system collects data of a similar nature to the additional axes and domains of ASIPS, including a harm scale, location check-box, event frequency scale, and details of patients such as age, gender and ethnicity 20. These elements are closed questions completed electronically by the reporter.…”

“…The Threats to Australian Patient Safety (TAPS) study estimated the incidence of GP-reported patient safety events in the community, using a method based on a randomly selected representative sample of GPs 20. We found that limitations mainly relating to the internal validity of existing tools warranted further taxonomy development.…”

Levels of agreement on the grading, analysis and reporting of significant events by general practitioners: a cross-sectional study

“…In one review of 15 studies, “errors” were estimated to happen in 1 in 120 patient consultations (0.8%), of which 60–83% were probably preventable 11. A recent Australian study in general practice found that the incidence of reported errors per patients seen per year was 0.24% 12. If we accept and extrapolate either figure, then with around 300 million patient consultations occurring in UK primary care annually,13 patient safety is potentially being compromised in a relatively large number of cases.…”