Harm caused by adverse events in primary care: a clinical observational study.
OBJECTIVE
Patient safety in primary care is important, but not well studied. The aim of our study was to determine the actual and potential harm caused by adverse events in primary care.


METHODS
Observational study in two general practices, including the patients of five doctors. Two methods were used to identify adverse events; (1) a prospective registration of adverse events by the general practitioner and (2) a retrospective audit of medical records. Actual harm was registered and a clinical analysis was made to estimate potential harm.


RESULTS
A total of 31 adverse events were collected and analysed. The adverse events were spread over different adverse event categories. About half of the events did not have health consequences, but a third led to worsening of symptoms and a few resulted in unplanned hospital admission. Potential negative health consequences were likely in three-quarters of the events.


CONCLUSIONS
The identified adverse events had some impact on health outcomes, but a risk for harm existed in a majority of the events. Patient safety programmes in primary care should focus on adverse events and not just on harm.
Wetzels
Raymond
R
Radbound University Nijmegen Medical Center, Nijmegen, The Netherlands.
Wolters
Rene
R
van Weel
Chris
C
Wensing
Michel
M