ReviewAnnals of family medicine2020
Impacts of Operational Failures on Primary Care Physicians' Work: A Critical Interpretive Synthesis of the Literature.
Review in Annals of family medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Integrating Self-Management Education and Support in Routine Care of People With Type 2 Diabetes Mellitus: A Conceptional Model Based on Critical Interpretive Synthesis and A Consensus-Building Participatory Consultation.Frontiers in clinical diabetes and healthcare · 2022Pooled it
- Using web-based training to improve accuracy of blood pressure measurement among health care professionals: A randomized trial.Journal of clinical hypertension (Greenwich, Conn.) · 2022Trial
- Electronic health record use factors linked to efficiency and productivity: an explainable machine learning analysis.JAMIA open · 2026Article
- Integrating equity into incident reporting and patient concerns systems: a critical interpretive synthesis.BMJ quality & safety · 2025Review
- Factors affecting cancer care delivery in primary care: a qualitative study.Family practice · 2025Article
- Understanding access to general practice through the lens of candidacy: a critical review of the literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Review
- Operational failures in general practice: a consensus-building study on the priorities for improvement.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Applying an equity lens to hospital safety monitoring: a critical interpretive synthesis protocol.BMJ open · 2023Article
- Using an electronic safety netting tool designed to improve safety with respect to cancer referral in primary care: a qualitative service evaluation using rapid appraisal methods.BMJ open quality · 2023Article
- Harnessing the Electronic Health Care Record to Optimize Patient Safety in Primary Care: Framework for Evaluating e-Safety-Netting Tools.JMIR medical informatics · 2022Article
- Identifying how GPs spend their time and the obstacles they face: a mixed-methods study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Operational failures and how they influence the work of GPs: a qualitative study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeOperational failures are system-level errors in the supply of information, equipment, and materials to health care personnel. We aimed to review and synthesize the research literature to determine how operational failures in primary care affect the work of primary care physicians.
methodsWe conducted a critical interpretive synthesis. We searched 7 databases for papers published in English from database inception until October 2017 for primary research of any design that addressed problems interfering with primary care physicians' work. All potentially eligible titles/abstracts were screened by 1 reviewer; 30% were subject to second screening. We conducted an iterative critique, analysis, and synthesis of included studies.
resultsOur search retrieved 8,544 unique citations. Though no paper explicitly referred to "operational failures," we identified 95 papers that conformed to our general definition. The included studies show a gap between what physicians perceived they should be doing and what they were doing, which was strongly linked to operational failures-including those relating to technology, information, and coordination-over which physicians often had limited control. Operational failures actively configured physicians' work by requiring significant compensatory labor to deliver the goals of care. This labor was typically unaccounted for in scheduling or reward systems and had adverse consequences for physician and patient experience.
conclusionsPrimary care physicians' efforts to compensate for suboptimal work systems are often concealed, risking an incomplete picture of the work they do and problems they routinely face. Future research must identify which operational failures are highest impact and tractable to improvement.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.