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Can Fam Physician
Vol. 53, No. 2, February 2007, pp.270 - 276
Copyright © 2007 by The College of Family Physicians of Canada
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Research

Errors and adverse events in family medicine

Developing and validating a Canadian taxonomy of errors

Sarah Jacobs, MA
Student in the Department of Public Health Sciences at the University of Toronto in Ontario.

Maeve O’Beirne, MD PhD CCFP
Assistant Professor in the Departments of Family Medicine and Community Health Sciences at the University of Calgary in Alberta.

Luz Palacios Derfiingher, MSc and Lucie Vlach
Primary Care Research and Development Group in the Department of Family Medicine at the University of Calgary.

Walter Rosser, MD CCFP FRCP MRCGP(UK)
Chair of the Department of Family Medicine at Queen’s University in Kingston, Ont.

Neil Drummond, PhD
Associate Professor in the Departments of Family Medicine and Community Health Sciences at the University of Calgary

Correspondence to: Dr Neil Drummond, 1707 1632-14th Ave NW, Calgary, AB T2N 1M7; telephone 403 210-9246; fax 403 270-4329; e-mail ndrummon{at}ucalgary.ca.

OBJECTIVE To develop a taxonomy of errors derived solely from the content of error reports using Canadian data from the Primary Care International Study of Medical Errors.

DESIGN Secondary analysis of data from a descriptive, cross-sectional, self-report survey.

SETTING Community-based family medicine clinics.

PARTICIPANTS Family physicians.

INTERVENTION Implementation of an error-reporting system for family medicine.

MAIN OUTCOME MEASURES Type of error, type of causal factor.

RESULTS Six types of errors or adverse events (administrative, communication, diagnostic, documentation, medication, and surgical or procedural) and 10 causal factors (case complexity, discontinuity of care, failure to follow protocol or accepted practice, fatigue, gap in knowledge, high workload, insufficient information on pharmacologic properties of medication, medication side effects, relationship dynamics, and structural problems) were identified.

CONCLUSION Our taxonomy differs from that adopted by the Primary Care International Study of Medical Errors. We propose that our taxonomy is better suited for the purposes of family physicians reporting errors in Canada.


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