Doctors can play a major role in error-detection programs at hospitals, according to a new study in the August issue of the Journal of General Internal Medicine.
"Although systems of prospective error reporting are critical, physicians do not actively participate in most of these systems," the authors write in the study. "They are used primarily by pharmacists in medication error tracking and nurses in incident reporting."
In an interview, the lead author, Sarwat I. Chaudhry, M.D., an internist at the Yale University School of Medicine in New Haven, Conn., says physicians are a key link in error-tracking because they are on the front lines of clinical care.
Chaudhry says doctors in the study required two to four hours a week of extra work to discuss the errors and document them.
In the study, two doctors tracked errors reported by physicians and other staff treating 528 patients in the general medicine service at an unnamed hospital from October 2000 to April 2001.
The study uses the Institute of Medicine definition of an error: "Failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim." Errors that resulted in an adverse outcome were categorized as "adverse events," while those that did not result in patient harm were categorized as "near-misses."
The study found that 10.4% of patients experienced at least one error: 6.2% a near-miss and 4.2% an adverse event.
The study also found that drug errors were the most common type of error overall. One example was patients discharged without the right medications, Chaudhry says.
The authors write that most of the errors first detected by house staff, nurses, and laboratory technicians were adverse events, while most of the errors first detected by the attending hospitalists, pharmacists, and consultants were near-misses.