Featured Research

from universities, journals, and other organizations

Patient safety risks outside hospital walls

Date:
June 14, 2011
Source:
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College
Summary:
Ever since the Institute of Medicine issued its landmark report "To Err Is Human" in 1999, significant attention has been paid to improving patient safety in hospitals nationwide. In an examination of trends of malpractice claims, there has been a greater decline in the rate of paid claims for inpatient settings than outpatient settings, and in 2009, the number of malpractice claims for events resulting in paid malpractice claims in outpatient and inpatient settings were similar, according to a new study.

Ever since the Institute of Medicine issued its landmark report "To Err Is Human" in 1999, significant attention has been paid to improving patient safety in hospitals nationwide.

However, a high number of adverse events, including major injury and even death, occur in private physician offices and outpatient clinics as well. In a new study -- the first of its kind -- researchers at Weill Cornell Medical College found that the number and magnitude of events resulting from medical errors is surprisingly similar inside and outside hospital walls.

Published in the June 14 issue of the Journal of the American Medical Association (JAMA), the study uses malpractice claims data to assess the prevalence of adverse events in the outpatient setting. The researchers compared malpractice claims paid on behalf of physicians in hospitals versus doctors' offices, relying on data from the National Practitioner Data Bank from 2005 through 2009.

In 2009 alone, close to 11,000 malpractice payments were made on behalf of physicians. Analysis of the data showed that about half of these were for errors that occurred in the hospital setting and half for adverse outcomes resulting from errors at the doctor's office.

The researchers also found that adverse events in hospitals largely have to do with unsuccessful surgery, while negative outcomes in the outpatient setting are most often related to errors in diagnosis.

"Physician practices have not been the focus of patient safety research, much less of policy efforts to reduce medical error," says Dr. Tara Bishop, lead author of the new study and assistant professor of public health and medicine at Weill Cornell Medical College and a practicing physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Dr. Bishop and her co-authors -- all members of the Weill Cornell Medical College faculty -- hope to stimulate interest in this neglected arena with a view toward improving the safety record of outpatient care.

In contrast to the large, centralized nature of the hospital setting, outpatient care is prone to fragmentation. "Our findings may reflect a lack of coordination within and between doctors' offices," Dr. Bishop says. "For example, a primary care physician may refer a patient to a specialist -- but the actual appointment may never happen. A cardiologist may order a scan, unaware that it was already performed during a patient's hospital stay.

"The problems associated with outpatient safety may not be easy to fix, but the adoption of electronic health records is already improving communication between doctors," says Dr. Bishop.

"Patient safety is likely to improve markedly as more and more doctors' offices change the way their records are kept, updated and accessed."

In addition to diagnostic errors and adverse drug interactions, surgical errors are occurring with greater frequency in the outpatient setting. Increasingly, surgical procedures are taking place in doctors' offices, a trend driven in part by advances in minimally invasive surgical techniques that do not require a hospital stay.

As an internist who works in an outpatient setting herself, Dr. Bishop has witnessed the relative growth of outpatient compared to inpatient care: "We're treating more patients than ever, plus we're seeing sicker patients than we used to."

Implicit in the shift toward outpatient care is a commensurate challenge to reduce errors and ensure that patients benefit from the advanced treatments that are now widely available at private physician offices across the country. "Improving the safety of outpatient care will be difficult," says Dr. Lawrence Casalino, senior author of the study and chief of the Division of Outcomes and Effectiveness Research in the Department of Public Health at Weill Cornell Medical College. "But it is critical to the health of our patients that physicians and patient safety experts direct much more attention to this problem."

The study was also co-authored by Dr. Andrew M. Ryan, assistant professor of public health at Weill Cornell Medical College, and received funding from the Agency for Healthcare Research and Quality.


Story Source:

The above story is based on materials provided by New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. Note: Materials may be edited for content and length.


Journal Reference:

  1. Tara F. Bishop, Andrew K. Ryan, Lawrence P. Casalino. Paid Malpractice Claims for Adverse Events in Inpatient and Outpatient Settings. JAMA, 2011;305(23):2427-2431 DOI: 10.1001/jama.2011.813

Cite This Page:

New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. "Patient safety risks outside hospital walls." ScienceDaily. ScienceDaily, 14 June 2011. <www.sciencedaily.com/releases/2011/06/110614203627.htm>.
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. (2011, June 14). Patient safety risks outside hospital walls. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2011/06/110614203627.htm
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College. "Patient safety risks outside hospital walls." ScienceDaily. www.sciencedaily.com/releases/2011/06/110614203627.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
CDC Calls for New Ebola Safety Guidelines

CDC Calls for New Ebola Safety Guidelines

AP (Oct. 20, 2014) Centers for Disease Control and Prevention Director Dr. Tom Frieden laid out new guidelines for health care workers when dealing with the deadly Ebola virus including new precautions when taking off personal protective equipment. (Oct. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins