Causes of Clinical Errors: Perceptions of Family Medicine Residents in Murcia, Spain

Abstract

Objective: analyze the specific causes of clinical errors perceived by the residents of five promotions of Family and Community Medicine (fcm) in Murcia, Spain. Material and methods: descriptive, analytical and cross-sectional study on medical errors collected through survey, conducted in health centers of two fcm units, with residents promoted on 2007-2011, 2008-2012, 2009-2013, 2014-2010 and 2011-2015. Through an open question asked about the latest medical error that had been identified and recognized as a practical exercise at the beginning of five editions of the training activity of the theoretical and practical program on patient safety. The question was handed out; the response was anonymous, confidential, voluntary and handwritten. The data were analyzed using the classification of incidents due to the Regional Study of Incidents Arising from Care (rsiac). Results: 169 residents from a total of 174 attended five courses, and 165 answered the survey (response rate of the 97.6%); 94.6% acknowledged having made mistakes. Of those who responded, 132 described their last error (80%). Errors were grouped according to their root causes: diagnosis-related: 58 (37.4% errors); treatment: 52 (33.5%); care: 21 (13.5%); Healthcare communication: 15 (9.6%); management and information system: 9 (5.8%). Errors in diagnosis, treatment and care represented 84% of the total. All the specific causes of the errors were analyzed and detailed.
Conclusions: the majority of the residents has a constructive and self-criticism attitude, and is aware of having committed errors, whose identified causes, in order of importance, are related to the diagnosis, treatment and care. This information can be useful to adapt and improve the training of residents, whereas the causes of their errors as identified training needs.