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Research Outputs - Work Packages

Work Package 2


Research Topic

Developing a Taxonomy of Errors for Primary Care

Lead: Johann Wolfgang Goethe University, 

Contact: Kerstin Klemp

Description of work


Why the research topic is important:

Since the release of the Institute of Medicine (IOM) report "To Err is Human: Building a Safer Health System“ in 1999 the issue of patient safety became a major focus of research in many developed countries. This has been reflected in the increasing number of patient safety related publications in the last decade - from 59 to 164 articles per 100 000 MEDLINE publications. In order to improve patient safety it is necessary not only to describe and analyse the current ’state of the art’ in this area but also to ensure that we have the right tools for this purpose. The development of a patient safety incident classification (PSIC) taxonomy for primary care is critical to our understanding of the causes of harm.

Despite the awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there is no incident classification system established that is generally applicable to patient safety data in European primary care. Therefore our aim was to an overview over content and structure of existing classification systems and based on these findings to develop a patient safety incident classification system for European primary care.

What have we done (our methodology / approach?)

We conducted a systematic review to identify existent classification systems and to compare them regarding their prominent features. We then applied a selection of these classification systems to vignettes which highlighted examples of patient safety incidents to prove their usefulness. Following this process we then brought together a group of international experts to develop recommendations regarding the content and structure of a patient safety incident classification for primary care (PSIC-PC). Based on these preparatory steps we drafted a PSIC-PC and subjected this draft to a critical appraisal during a modified Delphi study with international experts in classification.

What is/are the key result(s) and why are the results important

We have now produced a preliminary PSIC-PC differing from other classifications in terms of the content. It takes into account the practical conditions in primary care as well as the theoretical knowledge arising from the human factors research.

Tools and Guidance notes

Journal papers


Conference proceedings

  • Developing a taxonomy of errors in primary care – tasks and the steps towards completion (K. Klemp, 26th International Conference of the International Society for Quality in Health Care" 12 – 14 November 2009, Dublin, Eire, Scientific community, policy makers, 700, International).
  • "Klassifikationssysteme zur Beschreibung und Analyse von unerwünschten Ereignissen in der Primärversorgung – Eine systematische Literaturrecheche" (K. Klemp, 44 Kongress für Allgemeinmedizin und Familienmedizin 23-25 September 2010, Dresden, Germany, Scientific community, 400, Germany).
  • "How to set up a reporting network in your country” (B. Hoffmann, LINNEAUS-EURO PC Conference 19-20 October 2010, Manchester, UK, Scientific community, civil community, 120, International).
  • "Patient Safety Incident Classification in Primary Care - Preliminary recommendations of an expert advisory group” (K. Klemp, 6th EQuiP Invitational Conference 07-09 April 2011, Copenhagen, Denmark, Scientific community, 300, International).
  • "Patient Safety Incident Classification in Primary Care - Results of an modified two-stage Delphi survey” (K. Klemp, 17th WONCA Europe Conference 07-11 September 2011, Warsaw, Poland, Scientific community, 300, International).
  • How to set up a reporting network in your country” (K. Klemp, LINNEAUS-EURO PC Conference 07-08 September 2011, Warsaw, Poland, Scientific community, 120, East Europe).

LINNEAUS deliverable(s)

Other LINNEAUS reports

  • LINNEAUS Milestone No. 8: Report on two workshops on diagnostic errors.
  • LINNEAUS Significant Achievement No. 3.5 "Report on further dissemination of learning processes regarding the prevention of ADEs and evaluation of health professionals’ education".
  • LINNEAUS Significant Achievement No. 3.6 "……" (due June 2012).
  • LINNEAUS Milestone No. 4: First draft of recommended taxonomy for errors in primary care.
  • LINNEAUS Significant Achievement No. 2.1 "Internet based reporting system" (due Month 38).
  • LINNEAUS Significant Achievement No. 2.2 "International comparison of errors" (due Month 44).