Developing a preliminary 'never event' list for general practice using consensus-building methods.

Area of Science:

• Patient Safety
• Primary Care Medicine
• Healthcare Quality Improvement

Background:

• The 'never event' concept, proven in acute care, aims to prevent serious patient safety incidents.
• Implementation in hospitals increases awareness, promotes prevention, and facilitates reporting.

Purpose of the Study:

• To develop a preliminary list of never events specifically for general practice settings.
• To adapt the never event framework for primary care.

Main Methods:

• Consensus-building methods were applied in Scottish and UK general practices.
• 345 general practice team members suggested potential never events.
• A modified Delphi group and content validity index (CVI) exercise involving 17 UK primary care patient safety experts refined and validated the list.

Main Results:

• 721 suggestions were received, reduced to 38 potential never events through thematic categorization.
• Five general practice-specific criteria yielded 11 candidate never events.
• A preliminary list of 10 never events was endorsed by experts, achieving a CVI score >80%.

Conclusions:

• A preliminary list of never events for general practice was successfully developed.
• This represents a significant initial step in evaluating the never event concept's utility in primary care.
• Further testing is planned to assess the list's acceptability, feasibility, and potential as a safety intervention.