New electronic clinical decision support (CDS) systems are intended to reduce medical errors but sometimes have the unexpected and perverse effect of overwhelming physicians with potential warnings about trivial events, particularly regarding drug-drug interactions.
Hospitals that perform better on the survey tend to do better on clinical measures, have fewer readmissions within 30 days and have lower risk-adjusted mortality, write Marc Elliott and Alan Zaslavsky.
Examines co-occurrence of iatrogenic events in US hospitals. Using Agency for Healthcare Research and Quality patient safety indicators (PSIs), the authors defined multiple patient safety events (MPSEs) as the occurrence of multiple PSIs during a single hospitalization.
Quality of prescribing for older vets -- measured by high-risk medications and drug--disease interactions -- varies across VA facilities. Prescribing is better at facilities that care for a larger number of older veterans and have formal geriatric education.
In offices where e-prescribing was implemented, prescribers used information about formularies and drug benefits, but missing information reduced confidence in these resources and led to paper-based workarounds.
The most comprehensive analysis of the risk of malpractice claims by physician specialty in more than two decades finds that U.S. physicians have a greater than 75% career-long risk of facing litigation. In some specialties, doctors can be virtually certain of a lawsuit over the course of their careers. However, the vast majority of those claims will not result in payment to a plaintiff.
The likelihood of malpractice suits and the size of indemnity payments vary across specialties, but by age 65, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties.
Four domains of contextual features seem important for implementing patient safety practices: safety culture and teamwork, structural organization, external factors such as regulation, and availability of implementation and management tools.
This article describes the performance of hospitals' adverse-event reporting systems and the effects of national patient-safety initiatives, including the Patient Safety and Quality Improvement Act of 2005.