‘Tempos’ key to risk-management
Better time management by GPs could have a substantial impact on risk-management and patient outcomes in primary care, study findings indicate.
The researchers suggest that the "art of medicine" is to control each of five time scales, or "tempos", with the disease-specific tempo showing the greatest involvement in malpractice claims.
"In medicine, with some exceptions, time has not usually been conceptualized as a main component of error analysis, nor has it been considered in safety culture, quality approaches, or even WHO curricula for patient safety," observe René Amalberti (HAS and La Prévention Médicale, Saint Denis la Plaine) and co-author in BMJ Quality and Safety.
For the study, the team reviewed 623 malpractice claims, looking for five types of time-related problems (or tempos): disease, office, patient, out-of-office coordination/referral, and access to knowledge.
Missed/delayed diagnosis was the top cause for legal action, and this was most commonly associated with disease tempo. Errors managing care and adverse drug-related events were the next two most common reasons for claims. "The disease tempo appears to be a cornerstone in managing risk," write the researchers, and, combined with unsafe control of patient tempo, "may lead to numerous GP errors."
The investigators propose a number of specific strategies to help GPs improve their time management skills, concluding: "This framework may help to standardise training and provide a safer agenda for day-to-day activities."
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Sarah Guy