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Errors and adverse events in family medicine: developing and validating a Canadian taxonomy of errors.

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.