Table 2 Clinical cases
From: Patient safety in primary care: a survey of general practitioners in the Netherlands
| Â | Theme | Patient safety judged to be at risk (% GPs) |
|---|---|---|
1. A mother calls about her three-year-old daughter who has a fever. The medical assistant who handled the call did not detect any alarming symptoms and provided advice in keeping with guidelines. Given that it was very busy in the practice, the medical assistant did not enter the advice provided into the patient's electronic medical record. | Content of medical record | 85.5% |
2. The electronic medical record of a GP produces a lot of medication interaction warnings. The GP often ignores these without reading the warnings carefully. | Medication | 85.3% |
3. A cardiologist prescribes a patient a new ACE inhibitor within the context of a clinical trial. The patient already has chronic kidney failure. The GP considers checking the suitability of the medication to be entirely the responsibility of the cardiologist and therefore takes no action. | Medication | 76.5% |
4. A GP prescribes a NSAID for a ankle distortion to a 70-year-old male with no GI complaints or other medicines for a period of three days. The GP does not give gastric protection. | Medication | 73.5% |
5. A practice does not discuss errors made in the practice on a regular basis. Errors are resolved on an ad hoc basis by the healthcare workers involved. | Error discussion | 51.5% |
6. A study shows a patient to have to wait more than 10 minutes to speak to a medical assistant on the regular practice telephone number 40% of the time. | Telephone accessibility | 26.5% |
7. There has been a miscommunication between medical assistant and patient with regard to appointment time; the patient does not show up for appointment. The GP does not know what complaint the patient was coming for or when the patient may show up. | Miscommunication | 22.1% |
8. A 65-year-old man wants to know his PSA level. He has no prior complaint and the family history is negative. The GP discusses the advantages and disadvantages of drawing the PSA. Despite the possible disadvantages, the GP decides to draw the PSA because the patient wants to know his PSA value | Preventive medicine | 20.5% |
9. A patient is admitted to the hospital with a perforated appendix. Earlier that day, the patient was seen by a GP. The GP gave clear instructions on when the patient should return to see him, and the patient indeed returned to see him. | Diagnostic process | 17.6% |
10. In a general practice, small surgical procedures which require suturing are done without sterile gloves. | Hygiene | 10.3% |