Patient safety and the control of time in primary care: A review of the French tempos framework by the LINNEAUS collaboration on patient safety in primary care

Background: The tempos framework provides GPs with a flexible and practical guide to reflect on their organization and practices in the analysis of adverse events and supplement existing classification systems. The tempos framework specifies five timescales that need to be managed by physicians: the disease's tempo (unexpected rapid changes, slow reaction to treatment); the office's tempo (day-to-day agenda and interruptions); the patient's tempo (time to express symptoms, compliance, and emotion); the system's tempo (time for appointments, exams, and feedback); and the time to access to knowledge. Objective: This paper reviews the tempos framework and two studies that underpin its conceptual development. Methods: Two databases were used. Results: The use of the framework as a mechanism for analysing insurance claims is described. A comparison of using the tempos framework and standard patient safety classifications for analysing insurance claims is also described and showed that the concordance among coders was better for the tempos framework. The tempos framework fits closely with key principles of general practice and has potentially high relevance for analysing a patient's journey and continuity of care. The tempos framework seems most useful for GPs when analysing adverse events in their practice. Conclusion: Further work needs to be done to assess its generalizability and to formally assess its validity and reliability.