Operational failures and how they influence the work of general practitioners: A qualitative study in primary care

Operational failures are common in general practice and short-term workarounds are hiding the scale of the problem.

Operational failures, defined as inadequacies or mistakes in the information or items needed for patient care, are common in hospitals. This paper reports that operational failures such as delays in correspondence, broken equipment, troublesome IT, or frequent interruptions are also common in general practice. GPs often do extra work to compensate, such as chasing up missing test results. This solves the immediate problem. But it can also unintentionally hide the underlying problem and so create more work in the long run. Understanding the consequences of different operational failures and prioritising improvement efforts should be a key goal of future work to support general practice.

Why it matters?

Primary care faces a workforce crisis. Two-thirds of GPs report unmanageable workloads, and almost half report emotional exhaustion associated with their work. Strategies to address the problems have focused mostly on trying to train more GPs, diversify roles, and enhance retention. But improving working conditions might help greatly too. As the COVID-19 pandemic unfolds, it is more important than ever that operational systems support healthcare professionals in primary care, especially given the extra complexity involved in remote working.

Related content from our open-access series, Elements of Improving Quality and Safety in Healthcare