Accreditation practice pointer: near misses and adverse events

QI3.1 A Our practice monitors, identifies, responds to and reports near misses and  adverse events in clinical care.

RACGP Standards for general practice.

Patient safety incidents are a reality in general practice. A patient safety event that has the potential to cause harm is a ‘near miss’, while an event that does cause harm is an ‘adverse event’.  

In the interest of patient safety, general practices must have a process to reduce the likelihood of these events from happening again. This can be achieved by maintaining an incident or event register. Practices must also review existing monitoring processes and activities to identify any deficiencies or amendments that are required. 

General practices that do not address patient safety incidents also increase the risk of medico-legal action. Practices might ask the medical defence insurer to check and approve the incident and event register.  

General practice can also reduce near misses and adverse events by:

  • implementing and maintaining a clinical risk management policy

  • establishing a system so that members of the practice team know how to report a near miss or adverse event, and that they can do so without fear of recrimination

  • conducting clinical audits

  • making and documenting changes to reduce the risk of identified issues and to prevent adverse outcomes

  • keeping a record of team meetings and planning meetings where risks are discussed.

Margot Schoonmaker