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David Westfall Bates, David Michael Levine, Hojjat Salmasian, Ania Syrowatka, David M. Shahian, Stuart R. Lipsitz, Jonathan P. Zebrowski, Laura C. Myers, Merranda S. Logan, Christopher G. Roy and 11 more
BACKGROUND: Adverse events during hospitalization are a major cause of patient harm, as documented in the 1991 Harvard Medical Practice Study. Patient safety has changed substantially in the decades since that study was conducted, and a more current assessment of harm during hospitalization is warranted. METHODS: We conducted a retrospective cohort study to assess the frequency, preventability, and severity of patient harm in a random sample of admissions from 11 Massachusetts hospitals during the 2018 calendar year. The occurrence of adverse events was assessed with the use of a trigger method (identification of information in a medical record that was previously shown to be associated with adverse events) and from review of medical records. Trained nurses reviewed records and identified admissions with possible adverse events that were then adjudicated by physicians, who confirmed the presence and characteristics of the adverse events. RESULTS: In a random sample of 2809 admissions, we identified at least one adverse event in 23.6%. Among 978 adverse events, 222 (22.7%) were judged to be preventable and 316 (32.3%) had a severity level of serious (i.e., caused harm that resulted in substantial intervention or prolonged recovery) or higher. A preventable adverse event occurred in 191 (6.8%) of all admissions, and a preventable adverse event with a severity level of serious or higher occurred in 29 (1.0%). There were seven deaths, one of which was deemed to be preventable. Adverse drug events were the most common adverse events (accounting for 39.0% of all events), followed by surgical or other procedural events (30.4%), patient-care events (which were defined as events associated with nursing care, including falls and pressure ulcers) (15.0%), and health care-associated infections (11.9%). CONCLUSIONS: Adverse events were identified in nearly one in four admissions, and approximately one fourth of the events were preventable. These findings underscore the importance of patient safety and the need for continuing improvement. (Funded by the Controlled Risk Insurance Company and the Risk Management Foundation of the Harvard Medical Institutions.).
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Bates, D. W., Levine, D. M., Salmasian, H., Syrowatka, A., Shahian, D. M., Lipsitz, S. R., Zebrowski, J. P., Myers, L. C., Logan, M. S., Roy, C. G., Iannaccone, C. K., Frits, M. L., Volk, L. A., Dulgarian, S., Amato, M. G., Edrees, H. H., Sato, L., Folcarelli, P. H., Einbinder, J. S., … Mort, E. A. (2023). The Safety of Inpatient Health Care. New England Journal of Medicine, 388(2), 142–153. https://doi.org/10.1056/nejmsa2206117
Bates, David Westfall, et al. "The Safety of Inpatient Health Care." New England Journal of Medicine, vol. 388, no. 2, 2023, pp. 142–153, https://doi.org/10.1056/nejmsa2206117.
Bates, David Westfall, David Michael Levine, Hojjat Salmasian, Ania Syrowatka, David M. Shahian, Stuart R. Lipsitz, Jonathan P. Zebrowski, et al. "The Safety of Inpatient Health Care." New England Journal of Medicine 388, no. 2 (2023): 142–153. https://doi.org/10.1056/nejmsa2206117.
Bates D. W., Levine D. M., Salmasian H. [и др.] The Safety of Inpatient Health Care // New England Journal of Medicine. — 2023. — Vol. 388, № 2. — P. 142–153. — URL: https://doi.org/10.1056/nejmsa2206117
@article{bates2023safety,
title = {{The Safety of Inpatient Health Care}},
author = {David Westfall Bates and David Michael Levine and Hojjat Salmasian and Ania Syrowatka and David M. Shahian and Stuart R. Lipsitz and Jonathan P. Zebrowski and Laura C. Myers and Merranda S. Logan and Christopher G. Roy and Christine K. Iannaccone and Michelle L. Frits and Lynn A. Volk and Sevan Dulgarian and Mary G. Amato and Heba H Edrees and Luke Sato and Patricia Henry Folcarelli and Jonathan S. Einbinder and Mark E. Reynolds and Elizabeth A. Mort},
journal = {New England Journal of Medicine},
year = {2023},
volume = {388},
number = {2},
pages = {142--153},
doi = {10.1056/nejmsa2206117},
url = {https://doi.org/10.1056/nejmsa2206117}
}TY - JOUR AU - Bates, David Westfall AU - Levine, David Michael AU - Salmasian, Hojjat AU - Syrowatka, Ania AU - Shahian, David M. AU - Lipsitz, Stuart R. AU - Zebrowski, Jonathan P. AU - Myers, Laura C. AU - Logan, Merranda S. AU - Roy, Christopher G. AU - Iannaccone, Christine K. AU - Frits, Michelle L. AU - Volk, Lynn A. AU - Dulgarian, Sevan AU - Amato, Mary G. AU - Edrees, Heba H AU - Sato, Luke AU - Folcarelli, Patricia Henry AU - Einbinder, Jonathan S. AU - Reynolds, Mark E. AU - Mort, Elizabeth A. TI - The Safety of Inpatient Health Care JO - New England Journal of Medicine VL - 388 IS - 2 SP - 142 EP - 153 PY - 2023 DA - 2023/01/11 DO - 10.1056/nejmsa2206117 UR - https://doi.org/10.1056/nejmsa2206117 ER -
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