Error Management in Outpatient Settingsgerman translation / full article
Focus Groups Involving Physicians and Medical Assistants
Background: To promote patient safety, outpatient practices are legally obliged to introduce error management as part of quality management. Critical incident reporting systems (CIRS) are considered important tools in this respect. Little is known about the implementation of error management in outpatient settings. CIRS are not utilized comprehensively in ambulatory care. The aim of this study was to assess perceptions and attitudes regarding error management and CIRS.Methods: As part of a wider project, we conducted three focus groups, involving 16 members of a practice network. Two groups of physicians and one group of health care assistants talked about error management in their practice and the use of CIRS. The discussions were recorded, transcribed and evaluated using qualitative content analysis.Results: The handling of critical incidents varied between practices, but few of them had established a systematic approach. The cause of adverse events was frequently attributed to the carelessness of single staff members. The reflection on systemic error causes therefore often did not take place. CIRS were also rarely used. Barriers to their use included the assumption among participants that their errors were of no relevance to other practices, and the high workload in every day practice.Conclusions: As a basis for systematic error management, the awareness of risks and sources of errors in practice procedures is insufficient in many practices. Specific interventions are required to establish a safety culture that actively involves error management. Further research is needed to identify discipline-specific differences in error management and best-practice examples.