[Clinical safety in primary care. The systemic approach (I)]

This collaborative work is consists of two articles. In the first we will analyse Clinical Safety from a systemic perspective. In the second, we will focus on specific medical errors, with particular attention to the diagnostic error. Epidemiological studies are based on clinical document audits, adverse event reports, standardised patients-who in turn may adopt the methodology of "unknown patients"-and direct observation of the clinical act. Institutional initiatives have been introduced from the APEAS and ENEAS studies, to create safer organisational environments, with emphasis on prescription safety. We examine these initiatives, taking particular interest in the strategies that are supported in the Electronic Medical Record, and which are able to improve the clinical act at the same time in which it occurs.