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- Patient Self-Management
Boodman SG. Washington Post. June 13, 2011:E1.
Journal Article > Study
What happens between visits? Adverse and potential adverse events among a low-income, urban, ambulatory population with diabetes.
Sarkar U, Handley MA, Gupta R, et al. Qual Saf Health Care. 2010;19:223-228.
Adverse events after hospital discharge are a known patient safety hazard, but similar events between ambulatory clinic visits are poorly described. This study longitudinally followed a vulnerable patient population with diabetes between clinic visits and discovered 86% experienced at least one adverse or potential adverse event during the 9-month observation period. Medication management was the most common domain identified, while 80% of all events had a combination of system, clinician, and patient factors contributing. The authors discuss the complex safety environment observed and highlight that patients themselves may be key vehicles for reducing events. A past AHRQ WebM&M interview discusses the challenges in safely caring for vulnerable patient populations in the ambulatory setting.
Journal Article > Study
Use of an interactive, telephone-based self-management support program to identify adverse events among ambulatory diabetes patients.
Sarkar U, Handley MA, Gupta R, et al. J Gen Intern Med. 2008;23:459-465.
Chronic disease care increasingly involves patients engaging in self-management activities outside of discrete clinical encounters—for example, diabetics must monitor their blood sugars at home. This study used retrospective analysis of data from an interactive telephone-based diabetes self-management system to characterize the types and severity of adverse events occurring between physician visits in a low health literacy patient population. The vast majority of patients experienced at least one adverse event, most of which were considered preventable. Most events were detected by prompts generated by the telephone-based system. This study is one of the first to address adverse events in ambulatory patients outside the context of clinician visits and provides a model for addressing patient safety in chronic disease management.
Watts E, Rayman G. Diabetes UK. London, UK; 2018.
Chronic disease management can add complexity to inpatient care regimens. Researchers worked with patients, system leaders, and clinicians to examine areas of risk for hospitalized patients with diabetes and determine solutions such as specialized teams, clinical leadership, and improved use of technology. A WebM&M commentary illustrated safety challenges associated with providing care for hospitalized patients with diabetes.