Despite a recent focus on reducing medical error rates and improving patient safety, the actual error rate may be 10 times greater than previously thought, says a HealthDay article based on a study in the April issue of Health Affairs.
For this study, researchers compared a new method for identifying medical errors called the Global Trigger Tool with the methods recommended by the Agency for Healthcare Research and Quality (AHRQ) and voluntary reporting. Applying both tools to 795 patient records, the researchers found the AHRQ methods identified 35 errors, while the Global Trigger Tool found 354 errors. Voluntary reporting detected 4 errors. Medication errors were most common, followed by errors in surgical and nonsurgical procedures and in common infections.
"The more you look for errors, the more you find," says lead researcher David C. Classen, who notes that the high error rates for hospitals can be attributed in part to sicker patients, a more complicated patient mix, and more medications. In addition, better methods exist for detecting errors, he adds.
The downside of the new tool, says the article, is that it takes more time and resources than other methods because it involves medical record review. The AHRQ methods rely on voluntary error reporting systems or coding systems that use records on patients' charts. However, the trigger tool could become part of electronic medical record systems, which would integrate it easily into the hospital.
Commenting on the study, John Birkmeyer, MD, director of the Center for Healthcare Outcomes and Policy at the University of Michigan, said that it's not surprising that "systems that rely on voluntary reporting would tend to let a high percentage of cases fall through the cracks." He noted, however, that a system such as the Global Trigger Tool can be "too sensitive and may pick up unimportant things."
More information on the study and other Health Affairs papers that examine the current state of US health care quality can be found at this link.
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