Error management in GP practices : an investment in the healthcare system? Results of an exploratory study among general practitioners

Abstract

Aim The implementation of an error management system is part of the legal obligations for outpatient practices in Germany. On the one hand, internal reflection and analysis provides opportunities for improving internal practice processes; on the other hand, the input of such findings on critical events into error reporting and learning systems can help to optimise the healthcare sector as a whole. Despite the potentially significant importance of error management, there are only a few studies that engage in the practical pursuit of this concept in GP practices. The objective of this interview study was therefore to examine the views and perceptions of GPs in terms of error management, error reporting and learning systems.

Subject and methods In the course of qualitative, semi-standardised interviews, a total of 44 GPs in Baden-Württemberg, Hesse, North Rhine-Westphalia, Rhineland-Palatinate, Saarland and Thuringia were questioned in 2023 and 2024. The interviews were then evaluated by means of a qualitative content analysis according to Mayring.

Results The results reveal significant differences in the understanding of and approach to structured error management among individual GP practices, which is attributable to divergent circumstances among other things, but also to different levels of knowledge concerning the topic. Although error management is considered to be valuable and associated with an expedient, continuous improvement of healthcare procedures, many general practitioners acknowledge that they are often unable to devote the necessary attention to the topic due to the high workloads in their daily practice routine. Nevertheless, there are frequent team meetings and attempts to eliminate individual sources of error. Cross-practice error reporting and learning systems are hardly used. A central problem perception is that the interviewed doctors often have the impression that the critical events occurring in their everyday practice environment are too specific for a cross-practice reporting system. All in all, those interviewed underlined a great need for further training and support in order to pursue effective error management.

Conclusion The results indicate that error management in GP practices has not yet reached its associated full potential. Beyond the widespread workload of GP teams, the reason for this is a lack of strategic training, among other things, but also frequently a lack of a clear basic understanding of what error management should involve and how it can be pursued efficiently in daily practice conditions. The use of cross-practice reporting system also entails technical hurdles. As GPs, in their role as practice managers or key figures, can have a strong influence on the error management culture of their practices, it will be relevant in the future to provide them with more support and orientation, but possibly also to create incentives for the implementation of effective error management and communication in the healthcare sector.