The Safety of Inpatient Health Care

Diagnostic Errors in Hospitalized Patients

“…Table 1 summarizes some of key studies that have examined the incidence of harmful diagnostic errors in hospitalized patients. [9][10][11][12][13][14][15][16][17][18][19][20][21] The chief limitation of reviewing random hospital admissions is that, since overall rates of diagnostic errors are still relatively low, a large number of case reviews are required to identify a sufficient sample of adverse outcomes to gain a meaningful understanding of the underlying process failure points and develop tools for remediation. Patient and provider surveys or data from malpractice claims can be high-yield starting points for research on process errors.…”

“…6,24 For example, a recently published study of 2809 random admissions in 11 Massachusetts hospitals identified 978 adverse events but only 10 diagnostic errors (diagnostic error rate, 0.4%). 19 This was likely because the trigger method used in the study did not specifically examine the diagnostic process as critically as done by the Safer Dx framework and DEER taxonomy tools, thereby underestimating the total number of diagnostic errors. Further, these ongoing studies (eg, UPSIDE, ADEPT) aim to employ new and upcoming advanced machine-learning methods to create models that can improve overall diagnostic performance.…”

Getting better: Staying ahead of the curve on patient safety

“…3 A recent study found at least one adverse event in nearly a quarter of all admissions to hospitals randomly sampled in the US state of Massachusetts. 4…”

“…3 A recent study found at least one adverse event in nearly a quarter of all admissions to hospitals randomly sampled in the US state of Massachusetts. 4 There have been some advances in specific areas, most prominently in healthcare-acquired infections, 5 led by reductions in catheter-related bloodstream infections. 6,7 It has been possible to reduce deaths related to cardiac surgery, 8 and general surgery 9 using quality improvement strategies and the World Health Organization (WHO) safe surgery checklist.…”

Safety in Health Care: An Essential Pillar of Quality

“…This study found that inpatient care leads to harm in nearly a quarter of patients, and that 1 in 4 of these adverse events are preventable. 3 Since the first HMPS study was published, efforts to improve patient safety have focused on identifying causes of medical error and the design and implementation of interventions to mitigate errors. Factors contributing to medical errors have been well documented: the complexity of care delivery from inpatient to outpatient settings, with transitions of care and extensive use of medications; multiple comorbidities; and the fragmentation of care across multiple systems and specialties.…”