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A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice
  1. Andrew Carson-Stevens1,2,3,4,
  2. Peter Hibbert3,5,
  3. Anthony Avery6,
  4. Amy Butlin1,
  5. Ben Carter1,
  6. Alison Cooper1,
  7. Huw Prosser Evans1,
  8. Russell Gibson1,
  9. Donna Luff7,8,
  10. Meredith Makeham3,
  11. Paul McEnhill1,
  12. Sukhmeet S Panesar4,
  13. Gareth Parry8,9,
  14. Philippa Rees1,
  15. Emma Shiels1,
  16. Aziz Sheikh4,8,10,
  17. Hope Olivia Ward1,
  18. Huw Williams1,
  19. Fiona Wood1,
  20. Liam Donaldson11,
  21. Adrian Edwards1
  1. 1Primary Care Patient Safety (PISA) Research Group, Primary and Emergency Care Research (PRIME) Centre Wales, School of Medicine, Cardiff University, Wales, UK
  2. 2Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
  3. 3Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  4. 4Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK
  5. 5Australian Patient Safety Foundation, Adelaide, Australia
  6. 6Division of General Practice, College of Community Health Sciences, University of Nottingham, Nottingham, UK
  7. 7Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts, USA
  8. 8Harvard Medical School, Boston, Massachusetts, USA
  9. 9Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
  10. 10Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  11. 11Department of Surgery and Cancer, Imperial College London, London, UK
  1. Correspondence to Professor Andrew Carson-Stevens; carson-stevensap{at}


Introduction Incident reports contain descriptions of errors and harms that occurred during clinical care delivery. Few observational studies have characterised incidents from general practice, and none of these have been from the England and Wales National Reporting and Learning System. This study aims to describe incidents reported from a general practice care setting.

Methods and analysis A general practice patient safety incident classification will be developed to characterise patient safety incidents. A weighted-random sample of 12 500 incidents describing no harm, low harm and moderate harm of patients, and all incidents describing severe harm and death of patients will be classified. Insights from exploratory descriptive statistics and thematic analysis will be combined to identify priority areas for future interventions.

Ethics and dissemination The need for ethical approval was waivered by the Aneurin Bevan University Health Board research risk review committee given the anonymised nature of data (ABHB R&D Ref number: SA/410/13). The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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