Health Leaders Call for Attention to Outpatient Care Errors

The seminal 1999 report from the Institute of Medicine helped to spur initiatives focused on medical errors at hospitals. Now, experts want similar efforts to target problems in ambulatory care.

The American Medical Association's news service reported Jan. 9 that several health leaders agree with a December 2011 report from AMA's Center for Patient Safety that found attention has been lacking to the patient safety hazards present in ambulatory care settings. The "Research in Ambulatory Patient Safety 2000-2010: A 10-year review" report said a review of studies indicates problems are widespread, but the latest research doesn't shed light on which problem causes the most harm and thus deserves the most attention, according to the article written by Kevin B. O'Reilly.

Outpatient safety took a back seat after the Institute of Medicine released a report in 1999 that helped to spur initiatives focused on medical errors at hospitals. Experts now want similar efforts to target problems in ambulatory care, O'Reilly reported.

Dr. Matthew Wynia, M.D., MPH, the center's director, and Dr. David C. Classen, associate professor of medicine at the University of Utah School of Medicine, co-wrote a Dec. 14, 2011, commentary in JAMA about this issue. They recommended additional research and engaging patients' families in identifying safety problems, O'Reilly reported.

His article says there is no U.S. estimate for the number of patients harmed by mistakes in outpatient settings, even though ambulatory care patient visits outnumber hospital admissions by a factor of 300 to 1.

The article says these are the six most common errors in outpatient care:

  • Medication errors, such as prescriptions for incorrect drugs or incorrect dosages
  • Diagnostic errors, such as missed, delayed, and wrong diagnoses
  • Laboratory errors, such as missed, delayed, and wrong diagnoses
  • Clinical knowledge errors, such as knowledge, skill, and general performance errors on the part of physicians and other clinicians
  • Communication errors, such as doctor-patient communication errors, doctor-doctor communication errors, or other miscommunications between parties
  • Administrative errors, such as errors in scheduling appointments and managing patient records

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