Building upon earlier work, the authors engaged a technical expert panel to reach consensus on a definition for omissions of care in nursing homes. The article details the terms and concepts included in (and excluded from) the proposed definition, provides examples of omissions of care, intended uses (e.g., to guide quality improvement activities or training and education), and describes the implications of the definition for clinical practice, policy, and research.  

To support the development of a uniform definition of omissions of care in nursing home settings, the authors conducted a thematic analysis of 34 articles describing existing definitions and found broad agreement that delays or failure of care constitutes an omission of care, but differing views on whether to include adverse events in the definition of omissions of care. The authors reviewed an additional 327 articles reporting adverse events attributable to omissions of care, and identified nineteen event types, with the most common being all-cause mortality, falls, and infections.

Determining the severity of harm or potential harm is a challenge in patient safety. Investigators asked physicians, nurses, and pharmacists to rate the severity of harm for specific adverse events including falls, health care–associated infections, pressure ulcers, and blood product errors. The authors recommend using two raters to determine harm in order to achieve reliable estimates.

Accidental overuse of opioid medications in the ambulatory environment is a prominent patient safety concern. This commentary reviews a national plan to curb adverse drug events and applies those recommendations to guide efforts to improve opioid safety.

Adverse drug events continue to contribute to preventable errors for both hospitalized and ambulatory patients. This commentary describes the development and implementation plans of a national effort to reduce adverse drug events in the United States.