Relationship Between Patient Harm and Reported Medical Errors in Primary Care: A Report from the ASIPS Collaborative

Context: Harm associated with primary care medical errors is not well described. Objective: The objective of this project was to investigate the relationship between primary care medical errors and patient harm. Main Outcome Measures: The principal outcome measures for this study were: association between specific attributes of medical errors and levels of patient harm and frequency of harm classified hierarchically into five categories: (1) unknown or no known harm, (2) unstable or too early to tell if harm has occurred, (3) patient discomfort or inconvenience, (4) increased risk to patient or others, and (5) known clinical harm to the patient. Results: Clinical harm to the patient was reported in more than 10 percent of the 608 medical error reports. Prescription-related errors were most frequently associated with clinical harm (OR 5.25; 95 percent CI, 3.0-9.19; P <0.01). Conclusion: Errors in certain processes and systems are associated with patient harm in primary care. These findings might help prioritize the key areas of clinical care that warrant further study and intervention to improve patient safety.