The following is a summary of “Blackbox error management: how do practices deal with critical incidents in everyday practice? A qualitative interview study,” published in the November 2023 issue of Primary Care by Bodek, et al.

Error management is crucial for patient safety, involving a systematic approach to identifying, reporting, documenting, and learning from critical incidents. However, little was known about how outpatient physicians perceive critical incidents and implement error management in ambulatory care. For a study, researchers sought to explore physicians’ perspectives on error management, identify critical incidents, and understand the practical application of error management in outpatient settings.

Seventy-two semi-structured interviews were conducted with physicians from ambulatory practices. Participants were questioned about their definition of critical incidents, their reactions following incidents, discussions with colleagues about incidents, and the use of critical incident reporting systems. Transcripts were verbatim and analyzed using qualitative content analysis.

Physicians had varied definitions of “critical incident.” Most participants reported recording incident information and discussing them within their teams. Some physicians adopted a ‘pay better attention next time’ approach to incident analysis. However, systematic error management, encompassing incident documentation, analysis, preventive measures, and follow-up, was infrequent.

The study suggested a need for enhanced medical training that includes education on critical incidents and their open and structured management. Establishing a culture of safety, a long-standing international goal, can be facilitated by integrating error management principles into medical education, fostering a proactive and systematic approach to patient safety among medical professionals in outpatient care.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02206-2