title: Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study.
abstract: BACKGROUND
  Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to show areas where potential improvements could be implemented.
  
  
  METHODS
  We conducted a retrospective review of patient records in Dutch general practice. A random sample of 1,000 patients from 20 general practices was obtained. The number of patient safety incidents that occurred in a one-year period, their perceived underlying causes, and impact on patients' health were recorded.
  
  
  RESULTS
  We identified 211 patient safety incidents across a period of one year (95% CI: 185 until 241). A variety of types of incidents, perceived causes and consequences were found. A total of 58 patient safety incidents affected patients; seven were associated with hospital admission; none resulted in permanent disability or death.
  
  
  CONCLUSIONS
  Although this large audit of medical records in general practices identified many patient safety incidents, only a few had a major impact on patients' health. Improving patient safety in this low-risk environment poses specific challenges, given the high numbers of patients and contacts in general practice.
authors.affiliation: IQ healthcare, Radboud University Nijmegen Medical Centre, the Netherlands, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands. s.gaal@iq.umcn.nl
authors.forename: Sander
authors.initials: S
authors.lastname: Gaal
authors.forename: Wim
authors.initials: W
authors.lastname: Verstappen
authors.forename: René
authors.initials: R
authors.lastname: Wolters
authors.forename: Henrike
authors.initials: H
authors.lastname: Lankveld
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D058006:General Practice / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008485:Medical Audit; D019300:Medical Errors / Q000009:adverse effects / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D061214:Patient Safety / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies