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Journal Article > Commentary
Weingart SN, Wilson RM, Gibberd RW, Harrison B. BMJ. 2000;320:774-777.
This article summarizes the epidemiology of medical errors. The authors provide findings from benchmark studies to describe the prevalence and consequences of errors in the hospital setting. They also explore similar data for the outpatient setting, which are limited. Following this background, they discuss types of error, including complications from drug treatment, therapeutic mishaps, and diagnostic failures. The authors illustrate the number of preventable adverse events and those resulting in permanent disability. They explain a strategy to prevent errors by identifying individuals at high risk, such as elderly patients or those undergoing planned high-risk surgical procedures. They conclude by expressing the challenges in error reporting and emphasizing the fact that risk is not homogenous. This article is from a British Medical Journal special issue on patient safety.
Journal Article > Study
Matlow AG, Baker GR, Flintoft V, et al. CMAJ. 2012;184:E709-E718.
Hospitalized children are particularly vulnerable to specific types of errors, such as medication errors. This Canadian study used a trigger tool approach to estimate the frequency of all types of adverse events in hospitalized children, and found that nearly 1 in 10 pediatric patients suffers an adverse event while hospitalized. This prevalence is similar to classic studies performed in adult populations. Preventable adverse events, which accounted for approximately half of all events, were particularly common in children undergoing surgery or requiring intensive care. Diagnostic errors also accounted for a significant proportion of preventable adverse events. A preventable error in a critically ill 8-month-old child is discussed in an AHRQ WebM&M commentary.
Journal Article > Study
Automated identification of postoperative complications within an electronic medical record using natural language processing.
Murff HJ, FitzHenry F, Matheny ME, et al. JAMA. 2011;306:848-855.
Many adverse event identification methods cannot detect errors until well after the event has occurred, as they rely on screening administrative data or review of the entire chart after discharge. Electronic medical records (EMRs) offer several potential patient safety advantages, such as decision support for averting medication or diagnostic errors. This study, conducted in the Veterans Affairs system, reports on the successful development of algorithms for screening clinicians' notes within EMRs to detect postoperative complications. The algorithms accurately identified a range of postoperative adverse events, with a lower false negative rate than the Patient Safety Indicators. As the accompanying editorial notes, these results extend the patient safety possibilities of EMRs to potentially allow for real time identification of adverse events.