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Critical incidents in a tertiary care clinic for internal medicine

BACKGROUND: Reducing medical errors has become an international concern. Population-based studies consistently demonstrate inacceptable high rates of medical injury and preventable deaths. Thus, electronic critical incident reporting systems are now increasingly used in hospitals, predominantly in a...

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Autores principales: Scharein, Paula, Trendelenburg, Marten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729431/
https://www.ncbi.nlm.nih.gov/pubmed/23866793
http://dx.doi.org/10.1186/1756-0500-6-276
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author Scharein, Paula
Trendelenburg, Marten
author_facet Scharein, Paula
Trendelenburg, Marten
author_sort Scharein, Paula
collection PubMed
description BACKGROUND: Reducing medical errors has become an international concern. Population-based studies consistently demonstrate inacceptable high rates of medical injury and preventable deaths. Thus, electronic critical incident reporting systems are now increasingly used in hospitals, predominantly in anesthesia. However, studies systematically analyzing critical incidents are scarce. Our aim was to describe content and causes of critical incidents in our Clinic for Internal Medicine. RESULTS: We retrospectively analyzed all critical incidents reported during a 54-months period. Between implementation and analysis, 456 incidents were reported anonymously in the commercially available platform-independent, web-based critical incident reporting system. All incidents were analyzed according to the reporting profession, time point during hospitalization process, content and potential causes. Most incidents occurred on medical wards (80%). The most frequent type of incidents was medication errors (62%). These incidents primarily occurred when prescribing and/or administering drugs (30% and 29% of medication errors respectively). So-called, human errors’, i.e. occurring without apparent external factor, were the most frequently indicated cause of critical incidents (56%) followed by insufficient communication (26%). These problems primarily occurred between different groups of health care professionals and between different departments. The described types and reasons of critical incidents remained stable during the observation period. CONCLUSIONS: The findings of our analysis of the character and type of critical incidents occurring in a tertiary care clinic for internal medicine reported in an anonymous, voluntary, electronic reporting system suggest that strategies to improve communication and medication delivery are most promising to avoid critical incidents.
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spelling pubmed-37294312013-08-01 Critical incidents in a tertiary care clinic for internal medicine Scharein, Paula Trendelenburg, Marten BMC Res Notes Research Article BACKGROUND: Reducing medical errors has become an international concern. Population-based studies consistently demonstrate inacceptable high rates of medical injury and preventable deaths. Thus, electronic critical incident reporting systems are now increasingly used in hospitals, predominantly in anesthesia. However, studies systematically analyzing critical incidents are scarce. Our aim was to describe content and causes of critical incidents in our Clinic for Internal Medicine. RESULTS: We retrospectively analyzed all critical incidents reported during a 54-months period. Between implementation and analysis, 456 incidents were reported anonymously in the commercially available platform-independent, web-based critical incident reporting system. All incidents were analyzed according to the reporting profession, time point during hospitalization process, content and potential causes. Most incidents occurred on medical wards (80%). The most frequent type of incidents was medication errors (62%). These incidents primarily occurred when prescribing and/or administering drugs (30% and 29% of medication errors respectively). So-called, human errors’, i.e. occurring without apparent external factor, were the most frequently indicated cause of critical incidents (56%) followed by insufficient communication (26%). These problems primarily occurred between different groups of health care professionals and between different departments. The described types and reasons of critical incidents remained stable during the observation period. CONCLUSIONS: The findings of our analysis of the character and type of critical incidents occurring in a tertiary care clinic for internal medicine reported in an anonymous, voluntary, electronic reporting system suggest that strategies to improve communication and medication delivery are most promising to avoid critical incidents. BioMed Central 2013-07-16 /pmc/articles/PMC3729431/ /pubmed/23866793 http://dx.doi.org/10.1186/1756-0500-6-276 Text en Copyright © 2013 Scharein and Trendelenburg; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Scharein, Paula
Trendelenburg, Marten
Critical incidents in a tertiary care clinic for internal medicine
title Critical incidents in a tertiary care clinic for internal medicine
title_full Critical incidents in a tertiary care clinic for internal medicine
title_fullStr Critical incidents in a tertiary care clinic for internal medicine
title_full_unstemmed Critical incidents in a tertiary care clinic for internal medicine
title_short Critical incidents in a tertiary care clinic for internal medicine
title_sort critical incidents in a tertiary care clinic for internal medicine
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729431/
https://www.ncbi.nlm.nih.gov/pubmed/23866793
http://dx.doi.org/10.1186/1756-0500-6-276
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