Different Countries, Same Problem

Paul Levy

First published 4/25/11 on [Not] Running A Hospital

recent study* reported in Medscape Today summarized the likely factors leading to medical, medication and laboratory errors in eight countries — Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA. What is striking is the commonality across jurisdictions, irrespective of the type of health care organizational structure, including this conclusion: “Greater understanding by patients of the risks associated with health care could help to engage patients in participating in error-prevention strategies.” Here are some excerpts from the discussion portion of the article.

This study found . . . a number of statistically significant relationships between experiencing an error and a patient’s age, education level, presence of chronic conditions, prescription drug use, number of doctors seen, poor provider communication, poor care coordination and ED use. Overall, the three risk factors with the largest ORs** in the final regression model were (i) experiencing a care coordination problem, (ii) having seen four or more doctors within the last 2 years and (iii) having used the ED in the last 2 years. All three of these risk factors suggest issues with coordination, continuity of care and provider knowledge of the patient.

Experiencing a coordination problem had the largest OR of all the explanatory variables. This is consistent with literature that suggests that gaps in the continuity of care can create opportunities for errors to occur, and that hand-offs between health care professionals are an important element in ensuring greater patient safety.

Furthermore, gaps in coordination are an aspect of patient safety that is often very apparent to patients when they occur. Educating patients and increasing their degree of involvement in treatment plans may help to reduce the likelihood of errors occurring by empowering patients to speak up and ask questions about why certain tests are ordered and how they relate to their diagnosis.

* Andrea Scobie, “Self-reported Medical, Medication and Laboratory Error in Eight Countries,” International Journal for Quality in Health Care. 2011;23(2):182-186.
** The odds ratio (OR) for each explanatory variable was calculated to determine the relative risk of experiencing an error given each hypothesized risk factor.

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