Advertisement

Syndicate

The real scene of medical errors
Written by Ardena L. Flippin, MD, MBA   
Image

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?

Discuss this article on the forums. (0 posts)

 

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:
  • Failure to diagnose, e.g., cancer, myocardial infarctions, infections and fractures (3). Failure to diagnose can fall into two categories, those of commission, and omission (“Inadequate care for people with chronic illnesses was particularly common.”)(4)
  • Medication errors and adverse drug reactions
  • Abnormal test results, e.g., blood tests, imaging studies, Pap smears, procedural tests; tests that are incomplete, late, lost, wrong test performed, filing mistakes and/or lack of follow-up
  • No-shows and lack of follow-up when rescheduling is required
  • Referrals and lack of follow-up with consultant
  • Patient education (treatment, medication, informed consent)
  • Vaccines and maintenance procedures, e.g., breast and colon-rectal cancer screenings and pneumonia prevention. (3)

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. 

References

  1. Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. A report of the Committee on Quality of Heath Care in America. Institute of Medicine. Washington, DC: National Academy Press; 2000.
  2. Society for Ambulatory Anesthesia, “Patient Information”, (30 November 2001)
  3. ACP-ASIM Observer, June 2002. Strategies to tackle outpatient errors
  4. Hayward, R., Sins of Omission. Getting Too Little Medical Care May be the Greatest Threat to Patient Safety. J Gen Intern Med 2005; 20:686-691
  5. Phillips, RL. Learning from malpractice claims about negligent, adverse events in primary care in the United States. Qual Saf Health Care 2004; 13:121-126.

About the Author

Image

Dr. Flippin brings a wealth of experience, starting with her long tenure as an attending physician at the Cook County Hospital Emergency Department. She is currently Corporate Compliance and HIPAA Privacy Officer at major Chicago hospital.

Discuss this article on the forums. (0 posts)

 
< Prev   Next >

Common Diseases

Swine Flu - Updates and information on H1N1 2009 (AKA Swine Influenza) pandemic.

Ankylosing spondylitis - Current protocols for diagnosis and treatment options.

Wegener granulomatosis - Autoimmune etiology and clinical course.

Diabetes - disease and management information, including diagnosis, typical treatment plans and diabetes supplies.

Advertisement

Medical Careers

The US medical jobs market has stayed hot for health care providers. Whether you believe that a provider shortage is in the offing or that the ratio of physicians-to-patients is too high, physician jobs and nursing jobs abound.

A wide variety of medical jobs can be found in the netdoc health care job listings. Particular strengths include permanent and locum tenens physician jobs, nursing jobs across the US, and radiology positions.

Other resources include physician salary information, medical career guidance, and the ability to post physician jobs.

Polls

When hiring your medical practice office manager, what was the most important consideration?
 
Copyright 2005 - 2018 Medical Resource Group, LLC. All rights reserved.