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Frequency of Adverse Events Before, During, and After Hospital Admission

Lindsay D. Croft, MS, PhD, Michael E. Liquori, MD, James Ladd, MD, Hannah R. Day, MS, PhD, Lisa Pineles, MA, Elizabeth M. Lamos, MD, Preeti Mehrotra, MD, Eli N. Perencevich, MD, MS, Anthony D. Harris, MD, MPH, Daniel J. Morgan, MD, MS
Volume: 109 Issue: 10 October, 2016

Abstract:

Objectives: Adverse events (AEs) are unintended physical injuries resulting from or contributed to by medical or surgical care. We determined the frequency and type of AEs before, during, and after hospital admission.

Methods: We conducted a cohort study of 296 adult hospital patients. We used the standardized Institute for Healthcare Improvement Global Trigger Tool for Measuring Adverse Events to review the medical records of the hospital patients for occurrence, timing relative to hospital admission, severity, and preventability of AEs. We also identified the primary physiologic system affected by the AE.

Results: Among 296 patients, we identified 338 AEs. AEs occurred with similar frequency before (n = 148; 43.8%) and during hospital admission (n = 162; 47.9%). Fewer AEs occurred after discharge (n = 28; 8.3%). Half of all AEs (n = 169; 50.0%) were severe, whereas 47.9% (n = 162) were preventable.

Conclusions: AEs occur with similar frequency before and during hospitalization and may contribute more to hospital admissions than previously recognized. These findings suggest that efforts to improve patient safety should include outpatient settings in addition to the more commonly targeted acute care settings.

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References:

1. Institute for Healthcare Improvement. IHI global trigger tool for measuring adverse events. http://www.ihi.org/resources/Pages/Tools/IHI GlobalTriggerToolforMeasuringAEs.aspx. Accessed January 18, 2016.
 
2. Weingart SN, Wilson RM, Gibberd RW, et al. Epidemiology of medical error. BMJ 2000;320:774-777.
 
3. Classen DC, Resar R, Griffin F, et al."Global trigger tool"shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff (Millwood) 2011;30:581-589.
 
4. Naessens JM, Oɻ TJ, Johnson MG, et al. Measuring hospital adverse events: assessing inter-rater reliability and trigger performance of the Global Trigger Tool. Int J Qual Haelth Care 2010;22:266-274.
 
5. Unbeck M, Schildmeijer K, Henriksson P, et al. Is detection of adverse events affected by record review methodology? an evaluation of the"Harvard Medical Practice Study"method and the"Global Trigger Tool."Patient Saf Surg 2013;7:10.
 
6. Lakshmanan MC, Hershey CO, Breslau D. Hospital admissions caused by iatrogenic disease. Arch Intern Med 1986;146:1931-1934.
 
7. Day HR, Perencevich EN, Harris AD, et al. Depression, anxiety, and moods of hospitalized patients under contact precautions. Infect Control Hosp Epidemiol 2013;34:251-258.
 
8. Croft LD, Liquori M, Ladd J, et al. The effect of contact precautions on frequency of hospital adverse events. Infect Control Hosp Epidemiol 2015;36:1268-1274.
 
9. National Coordinating Council for Medication Error Reporting and Prevention. Index for categorizing medication errors. http://www.nccmerp.org/types-medication-errors. Accessed July 27, 2016.
 
10. Landrigan CP, Parry GJ, Bones CB, et al. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med 2010;363:2124-2134.
 
11. Rothschild JM, Landrigan CP, Cronin JW, et al. the Critical Care Safety Study: the incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med 2005;33:1694-1700.
 
12. Sharek PJ, Parry G, Goldmann D, et al. Performance characteristics of a methodology to quantify adverse events over time in hospitalized patients. Health Serv Res 2011;46:654-678.
 
13. Morgan DJ, Deloney VM, Bartlett A, et al. The expanding role of the hospital epidemiologist in 2014: a survey of the Society for Hospital Epidemiology of America (SHEA) Research Network. Infect Control Hosp Epidemiol 2015;36:605-608.
 
14. Morgan DJ, Croft LD, Deloney V, et al. Choosing Wisely in healthcare epidemiology and antimicrobial stewardship. Infect Control Hosp Epidemiol 2016;37:755-760.
 
15. Morgan DJ, Brownlee S, Leppin AL, et al. Setting a research agenda for medical overuse. BMJ 2015;351:h4534.

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