AMA Report Highlights Data Gaps for Safety in Outpatient Care

More medical liability claims come from ambulatory settings than anywhere else, but there is a "serious shortage of reliable data" to help those trying to improve the situation, it finds.

A new report from the American Medical Association points out big gaps in the medical profession's understanding of ambulatory care safety –- items such as preventing medication and diagnostic errors. An article in JAMA discusses the problem.

Why the gaps? For reasons such as studying events that caused harm by focusing on malpractice claims, which may or may not be ultimately meritorious, or on insurance claims, where often not enough information is presented to determine whether an error occurred and, if it did, whether the error could have been prevented. Many studies looked at both errors that caused harm and those that did not, but frequently they did not include an assessment of whether the errors were preventable, the report's authors concluded. It looked at medication safety, diagnostic errors, office-based surgery and anesthesia, patients’ role in care, and communication safety from 2000 to 2010.

The data gaps are significant because most care occurs in outpatient settings, not in hospitals, although hospitals have been studied to a much greater extent. There are 300 patients receiving ambulatory (outpatient) care for every patient admitted to a hospital, the report states.

"This report comes at an important time," said Dr. Gordon Schiff, associate director of the Center for Patient Safety Research and Practice at Brigham and Women's Hospital. "It's not about whether or not we need to do better in outpatient care, but how to best do that, especially given all the competing priorities for outpatient physicians."

AMA released a new medical disposal guide in conjunction with National Patient Safety Awareness Week; physicians can give copies of the guide to patient to remind them to dispose of expired/unwanted medications safely.

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