|The real scene of medical errors|
|Written by Ardena L. Flippin, MD, MBA|
Medical errors became a popular issue when the 1999 Institute of Medicine (IOM) report To Err is Human: Building a Safer Health System (1) cited it as cause for concern. The focus was on hospital-related errors because that is where they were well documented. Who knew that, due to the trend of increasing outpatient-care delivery and increasing patient loads, medical office errors might be responsible for the majority of medical errors?
According to the Agency for Healthcare Research and Quality, “Errors occur not only in hospitals but in other health care settings, such as physicians’ offices, nursing homes, pharmacies, urgent care centers, and care delivered in the home.” Nearly two-thirds of all surgical procedures are performed in the outpatient setting. (2) The IOM report estimates the cost of medical errors to be $37.6 billion each year, and about half of this is attributed to preventable errors.
Types of problems. The IOM defines medical errors as “the failure to complete a planned action as intended or the use of a wrong plan to achieve an aim.” Adverse events are defined as “an injury caused by medical management rather than by the underlying disease or condition of the patient.”Most common and most serious errors in primary care are caused by:
Error prevention. As varied as the above errors are, system errors and “the potential for relatively frequent systematic errors” (5) are cited as common reasons for medical errors.
Examples of how to improve an office system would be to combine reminder phone calls or mailings (to avoid no-shows) with a reminder to bring medication bottles or updated medication lists of all physicians the patient sees, use of information technology and standardized treatment policies and protocols.
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