PubMed Health⌕ Search

Biomedical subjects

A Bhasale

Publications and source records attributed to A Bhasale.

12 recordsLinked to original sources
PubMed1998

The wrong diagnosis: identifying causes of potentially adverse events in general practice using incident monitoring.

BACKGROUND: Although recognized by both patients and practitioners as a highly undesirable outcome, little is known about the factors which contribute to wrong diagnoses. Data collected through a pilot study of incident monitoring in general practice in Australia were examined to identify possible types of diagnostic incidents and their likely causes. OBJECTIVES: The aim was to identify how diagnostic incidents occur and to illuminate preventable and especially system causes of such incidents. METHODS: GP participants anonymously reported any event of potential harm to their patients, using both free text and structured-response categories. Free text was analysed qualitatively for common themes, while fixed format responses were used to provide an overall description of the data. RESULTS: Diagnostic incidents occurred because of errors in judgement, particularly in the formation and evaluation of diagnostic hypotheses. Other problems related to systems of information transfer and medical records, and to poor communication between patients and health providers and between health professionals, which resulted in less than ideal care. CONCLUSION: Incident monitoring is a useful tool for identifying sources of misdiagnosis and for implementation and assessment of quality improvement strategies.

Australia↗
PubMed1996

The sex of the general practitioner: a comparison of characteristics, patients, and medical conditions managed.

In Australia an increasing proportion of active general practitioners (GPs) are women. Overseas research showing differences between male and female GPs in practice style, the reasons patients consult them, or in the nature of the medical conditions they manage has failed to adjust for confounders. In Australia, such differences have never been investigated. This study assessed differences between male and female GPs in terms of their personal characteristics, patient mix, patient reasons for consultation, and the medical conditions they manage. It also considered the extent to which differences are accounted for by the effect of confounders. A secondary analysis was done of data from the Australian Morbidity and Treatment Survey 1990 to 1991 (n = 113,000 general practice encounters). In addition, univariate analysis was followed by multivariate analysis, with adjustments for GP and patient characteristics and (in analysis of conditions managed) for patient reasons for encounter. Significant differences were found in the work patterns and patient mix of male and female GPs. Patients' selectivity in the problems presented to the two groups remained after adjustment for confounders. Female GPs managed more female-specific, endocrine, general, and psychosocial problems even after multivariate adjustment. Although male GPs managed more cardiovascular, musculoskeletal, male genital, skin, and respiratory problems at the univariate level, these differences were no longer apparent after adjustment. Male and female GPs manage different types of medical conditions. Although some differences are due to their patient mix and to patient selectivity, others are inherent to the sex of the physician. Extrapolation of results to Australian general practice suggests that these two groups of GPs could become semispecialized.

Adult↗
PubMed1996

Warfarin prescribing.

The incident Monitoring in General Practice Project began as an initiative of the Professional Indemnity Review. Anonymous data from general practitioners about unintended, and possibly adverse events were collected in order to develop preventive strategies that might ultimately increase patient safety and therefore reduce litigation. Feedback and sharing of experiences and ideas about these events, possible management strategies or the project as a whole are invited from the readers.

Anticoagulants↗
PubMed1996

Clinical incidents in general practice. Communication between casualty departments and general practitioners.

The incident Monitoring in General Practice Project began as an initiative of the Professional Indemnity Review. Anonymous data from general practitioners about unintended, and possibly adverse events were collected in order to develop preventive strategies that might ultimately increase patient safety and therefore reduce litigation. Feedback and sharing of experiences and ideas about these events, possible management strategies or the project as a whole are invited from readers.

Australia↗
PubMed1996

Clinical incidents in general practice. A difficult paediatric diagnosis.

The Incident Monitoring in General Practice Project began as an initiative of the Professional Indemnity Review. Anonymous data from general practitioners about unintended, and possibly adverse events were collected in order to develop preventive strategies that might ultimately increase patient safety and therefore reduce litigation. Feedback and sharing of experiences and ideas about these events, possible management strategies or the project as a whole are invited from readers.

Child↗
PubMed1996

Tests and investigations. Indicators for better utilisation.

Diagnostic tests and investigations are standard tools for today's general practitioner. However, without reliable systems for the management of tests and test results, these valuable assets may become a liability to the GP, with the possibility of unforeseen adverse events arising at several points in the total investigative process. Exploring GPs' reports of such incidents may provide opportunities for improvements in patient care.

Communication↗
PubMed1996

Clinical incidents in general practice. Prescription errors.

The incident Monitoring in General Practice Project began as an initiative of the Professional Indemnity Review. Anonymous data from general practitioners about unintended, and possibly adverse events were collected in order to develop preventive strategies that might ultimately increase patient safety and therefore reduce litigation. Feedback and sharing of experiences and ideas about these events, possible management strategies or the project as a whole are invited from the readers.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Clinical incidents in general practice. Keeping on track with test results.

The incident Monitoring in General Practice Project began as an initiative of the Professional Indemnity Review. Anonymous data from general practitioners about unintended and possibly adverse events were collected in order to develop preventive strategies that might ultimately increase patient safety and therefore reduce litigation. Feedback and sharing of experiences and ideas about these events, possible management strategies or about the project as a whole are invited from readers.

Australia↗
PubMed1995

Asthma management and morbidity in Australian general practice: the relationship between patient and doctor estimates.

The aims of this study were to describe asthma management and morbidity in patients attending general practitioners in Australia, and to assess the relationship between patient reports and those of their general practitioner (GP). The sample comprised consecutive patients attending 46 general practitioners chosen at random in five regions of New South Wales, Australia. A total of 4538 patients were screened, 607 (13.4%) reported ever having diagnosed asthma, and the 501 who reported asthma in the previous 12 months completed a detailed questionnaire. Three hundred and thirty-four patients also had information about their asthma management recorded by their GP. The patient questionnaire asked about asthma symptoms, therapy, lung function measurement, and asthma-related morbidity. The GP questionnaire asked the doctor to record similar information about the patients. Two-thirds of the patients used regular inhaled beta 2-agonist medication, and one-half reported using preventive therapy. Only 24% owned a peak flow meter and 9% had a written plan of action for asthma attacks. Although preventive therapy and airway function assessment were more common in those with frequent symptoms (> 2-3 times per week), this group were still sub-optimally managed. In the matched sample (n = 334), doctors reported prescribing bronchodilator and preventive medication, measuring airway function and recommending peak flow meter use more often than suggested by patient-reported data. The study concludes that many patients do not attend for regular review, and that management remains sub-optimal, particularly in young adults. Data from patient surveys may underestimate clinical practice, as assessed from doctors' records. This should lead to patient-derived estimates of management being interpreted with caution in epidemiological studies. Further attention to patient understanding and compliance with prescribed asthma management advice is needed in order to better manage asthma in the community.

Adolescent↗