[Clinical error and adverse events: Primary care doctors perception]. / Errores clínicos y eventos adversos: percepción de los médicos de atención primaria.

OBJECTIVE: To evaluate how primary care physicians perceive and face clinical errors (CE) and/or adverse events (AE). DESIGN: Cross-sectional study (personal mail survey). SETTING. Primary care physicians from "Ambit Costa de Ponent." PARTICIPANTS: All doctors with tenure from this area (717). MAIN MEASUREMENTS: Standardized questionnaire with error and adverse event frequencies. We compared answers considering age, gender, family medicine residency, "deniers" (never make a mistake), "perceptive" (admitting a mistake in the last year), "hyper-perceptive" (28 or more errors/adverse events a year), "internal locus of control" (admitting personal reasons in errors), and "hypersecure" (>7 points out of 10 in clinical security on Likert scale). RESULTS: Two hundred thirty eight physicians (33.2%) with an average age of 42.6 (95% CI, 41.6-43.6) replied. The 28% were "deniers" (95% CI, 22.34-34.26), 67% "perceptive" (95% CI, 60.79-73.23), 7.4% "hyperperceptive" (95% CI, 4.41-11.44), 6% had "internal locus of control" (95% CI, 3.34-9.91), and 23.4% were "hypersecure" (95% CI, 18.14-29.22). Every doctor had on average 10.6 adverse events yearly, mainly drug side-effects (37%) (95% CI, 35.36-39.15), and diagnostic delay in oncology scenarios (33%) (95% CI, 31.16-34.85). The most common reaction to an error was to try and contact the patient (80%) (95% CI, 73.24-85.73) and to communicate the case to the team (41.4%) (95% CI, 33.97-49.22). CONCLUSIONS: AE and CE were recognized as frequent, but a third of doctors affirmed they never made a mistake. Young male physicians, unlike senior ones, communicate mistakes to the team. "Internal locus of control" and "hyperperceptive" professionals tended to have stronger emotional reactions after committing errors. Physicians felt less secure with ophthalmology and ENT problems; and older doctors added to these dermatology and palliative care.

Errores clínicos y eventos adversos: percepción de los médicos de atención primaria / Clinical error and adverse events: primary care doctors’ perception

Objetivo. Mostrar cómo el médico percibe y afronta los errores clínicos y/o acontecimientos adversos (Ec-Ea). Diseño. Estudio transversal (encuesta postal personalizada). Emplazamiento. Atención primaria del «Ámbito territorial Costa de Ponent». Participantes. Todos los médicos con plaza en propiedad en atención primaria (n = 717). Mediciones principales. Cuestionario estandarizado: frecuencia de errores y eventos adversos; comparación de las respuestas en función de la edad, el sexo, la formación MIR en medicina de familia, en los «negadores» (jamás se han equivocado de manera importante), los «perceptivos» (admiten errores en el último año), los «hiperperceptivos» (admiten 28 o más errores-acontecimientos adversos/año), los «loci internos» (admiten causas personales en los errores) y los hiperseguros (> 7 puntos sobre 10 en seguridad clínica escala de Likert). Resultados. Contestaron 238 médicos (33,2%), con una edad media de 42,6 años (intervalo de confianza [IC] del 95%, 41,6-43,6). El 28% eran «negadores» (IC del 95%, 22,34-34,26); el 67% «perceptivos» (IC del 95%, 60,79-73,23); el 7,4% «hiperperceptivos» (IC del 95%, 4,41-11,44); el 6%, «loci interno» (IC del 95%, 3,34-9,91), y el 23,4% hiperseguros (IC del 95%, 18,14-29,22). Se informó sobre 10,6 acontecimientos adversos/año/profesional, sobre todo eventos adversos de fármacos (37%) (IC del 95%, 35,36-39,15) y retraso diagnóstico en una enfermedad neoplásica (33%) (IC del 95%, 31,16-34,85). La reacción más frecuente era intentar contactar con el paciente (80%; IC del 95%, 73,24-85,73) y comentar el caso con el equipo (el 41,4%; IC del 95%, 33,97-49,22). Conclusiones. Los Ec-Ea se reconocen como frecuentes, pero un tercio de los médicos afirma no haberse equivocado nunca de manera importante. El médico varón joven, a diferencia del experimentado, socializa sus errores con el equipo. Los profesionales de «locus interno» e «hiperperceptivos» son proclives a reacciones emocionales más acusadas ante la comisión de errores clínicos. Los médicos reconocen menos seguridad en ORL y oftalmología y, además de éstos, los médicos experimentados también declaraban inseguridad en dermatología y cuidados paliativos

Objective. To evaluate how primary care physicians perceive and face clinical errors (CE) and/or adverse events (AE). Design. Cross-sectional study (personal mail survey). Setting. Primary care physicians from "Ambit Costa de Ponent." Participants. All doctors with tenure from this area (717). Main measurements. Standardized questionnaire with error and adverse event frequencies. We compared answers considering age, gender, family medicine residency, "deniers" (never make a mistake), "perceptive" (admitting a mistake in the last year), "hyper-perceptive" (28 or more errors/adverse events a year), "internal locus of control" (admitting personal reasons in errors), and "hypersecure" (>7 points out of 10 in clinical security on Likert scale). Results. Two hundred thirty eight physicians (33.2%) with an average age of 42.6 (95% CI, 41.6-43.6) replied. The 28% were "deniers" (95% CI, 22.34-34.26), 67% "perceptive" (95% CI, 60.79-73.23), 7.4% "hyperperceptive" (95% CI, 4.41-11.44), 6% had "internal locus of control" (95% CI, 3.34-9.91), and 23.4% were "hypersecure" (95% CI, 18.14-29.22). Every doctor had on average 10.6 adverse events yearly, mainly drug side-effects (37%) (95% CI, 35.36-39.15), and diagnostic delay in oncology scenarios (33%) (95% CI, 31.16-34.85). The most common reaction to an error was to try and contact the patient (80%) (95% CI, 73.24-85.73) and to communicate the case to the team (41.4%) (95% CI, 33.97-49.22). Conclusions. AE and CE were recognized as frequent, but a third of doctors affirmed they never made a mistake. Young male physicians, unlike senior ones, communicate mistakes to the team. "Internal locus of control" and "hyperperceptive" professionals tended to have stronger emotional reactions after committing errors. Physicians felt less secure with ophthalmology and ENT problems; and older doctors added to these dermatology and palliative care