Professional misconduct and errors in medical practice

Overview

Background:
Mistakes of all kinds are a normal part of the workplace. There are a great number of unexpected events and situations that can potentially harm patients. Some of these are consequences of medical errors, but many errors are preventable. There is no system of registration, analysis or communication of errors and adverse events established in primary care in the Czech Republic either formally or informally.

Aim and methods:
The aim of our work was to identify the most frequent medical errors, which occur in general practice settings in the Czech Republic, and to place them in the existing International Classification of Medical Errors. We studied the frequency and severity of errors and their possible impact on patient safety. Furthermore, we searched for preventive strategies and organizational measures in general practice in order to diminish the vulnerabilities that have been identified. A comprehensive literature review on medical errors was used to prepare a focus group comprised of general practitioners (GPs). The outcomes were presented and discussed at a workshop at the GP Society’s annual conference.

Results:
GPs in three focus groups identified 128 medical errors. Medical errors were classified according to the International Classification of Medical Errors. Errors caused through communication failure were the most frequent, and this failure in communication occurred either between medical personnel and the patient, physician and nurse or was the result of a breakdown in interdisciplinary communication. Errors occur in clinical activities, in diagnostic or therapeutic processes, procedures, interpretation of results, prescription etc.. Administrative errors can have serious consequences for patients – where there is a mix up between patients, drugs or results. In order to improve the quality and safety of patients, the errors should be registered and analysed and the appropriate measures should be implemented. The example of a registration list of medical errors in general practice is a part of our work. Learning and sharing knowledge and experience about medical errors is essential in order to prevent them occurring, but the creation of such a model seems to be very difficult.

Key words:
medical errors, patient safety, quality of care, general practitioner.