Event Reporting to a Primary Care Patient Safety Reporting System: A Report From the ASIPS Collaborative

Fernald, Douglas H.; Pace, Wilson D.; Harris, Daniel M.; West, D. R. F.; Main, Deborah S.; Westfall, John M.

doi:10.1370/afm.221

Cited by 130 publications

(121 citation statements)

References 18 publications

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“…10,12 The age, sex, reason for call, time of follow-up visit, physician-documented outcome, and treatment were coded using the ASIPS Dimensions of Medical Outcomes (DMO) taxonomy, which has been previously described. 14 Briefly, a team of trained coders (made up of 3 members, including one physician) reviewed and assigned all relevant codes from the DMO taxonomy to each event in a consensus approach. The team reviewed each of 119 abstracted cases and applied codes describing the outcome of the event which included: 1) the level of harm to the patient, 2) change in the status of the patient, and 3) any intervention required as a result of the delay in communication between the patient and the on-call physician.…”

Section: Methodsmentioning

confidence: 99%

Harm Resulting from Inappropriate Telephone Triage in Primary Care

Hildebrandt¹,

Westfall²,

Fernald³

et al. 2006

The Journal of the American Board of Family Medicine

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Purpose: Our objective was to assess and categorize harm occurring to patients who called their physicians' office after-hours but did not have their call forwarded to the physician because they stated that their call was not an emergency.Methods: We collected data on 4949 calls handled by our answering service for 1 year in a family medicine residency office in Denver, CO. Of the 2835 after-hours clinical calls, we reviewed all 288 clinical calls that were not forwarded to the "on-call" physician. Complete data on 119 clinical calls included reason for call, frequency of next day appointments, Emergency Department visits, hospital admissions and outcomes. Outcomes were reviewed and coded for harm to the patient by experienced medical errors coders.Results: When patient calls were not forwarded, 51% had an appointment, 4% an Emergency Department visit, and 2% were admitted to the hospital within 2 weeks. Analysis revealed that 3% suffered harm, and 26% experienced discomfort due to the delay. Although 66% required no intervention, 1% required emergency transport and 4% a medication change. Conclusions: Harm may occur when patients' calls are not forwarded to the on-call physician. Although the level of harm is generally temporary and minimal, the potential exists for serious harm to occur. Physicians need to re-evaluate the way they handle after-hours calls. (J Am Board Fam Med 2006; 19:437-42.)Over the past 10 years, the majority of studies of patient safety have focused on the hospital setting. A great deal of time, money, and energy has been spent identifying types of errors and system problems.1-3 The frequency of errors has varied from 6% to 18% with only a small portion of those errors resulting in permanent harm or death to the patients treated. 4 Naturally, serious harm has garnered the most attention. 5 Recently, attention has been focused on the ambulatory care settings, where errors may be even more frequent. For example, in the ambulatory care setting, adverse drug events may occur at a rate that is 4 times higher than that found in the hospital setting.

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Section: Methodsmentioning

confidence: 99%

Harm Resulting from Inappropriate Telephone Triage in Primary Care

Hildebrandt¹,

Westfall²,

Fernald³

et al. 2006

The Journal of the American Board of Family Medicine

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“…[1][2][3] Primary care physicians perceive time limitations and disorganized work systems as factors that influence safety, 4,5 with communication, medication management, and test results tracking believed to be common sources of avoidable error. 2,3,6,7 Work is underway to develop consensus about key processes and metrics to promote systematic safety monitoring and reduce risk in primary care. 8 While working to develop these metrics, culture assessments have been used as indirect safety measures.…”

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confidence: 99%

Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

et al. 2012

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BACKGROUND: Increasing the use of electronic medical records (EMR) has been suggested as an important strategy for improving healthcare safety. OBJECTIVE: To sequentially measure, evaluate, and respond to safety culture and practice safety concerns following EMR implementation. DESIGN: Safety culture was assessed using a validated tool (Safety Attitudes Questionnaire; SAQ), immediately following EMR implementation (T1) and at 1.5 (T2) and 2.5 (T3) years post-implementation. The SAQ was supplemented with a practice-specific assessment tool to identify safety needs and barriers. PARTICIPANTS: A large medical group practice with a primary care core of 17-18 practices, staffed by clinicians in family medicine, pediatrics, internal medicine. INTERVENTIONS: Survey results were used to define and respond to areas of need between assessments with system changes and educational programs. MAIN MEASURES: Change in safety culture over time; perceived impact of EMR on practice. KEY RESULTS: Responses were received from 103 of 123 primary care providers in T1 (83.7 % response rate), 122 of 143 in T2 (85.3 %) and 142 of 181 in T3 (78.5 %). Safety culture improved over this period, with statistically significant improvement in all domains except for stress recognition. Time constraints, communications and patient adherence were perceived to be the most important safety issues. The majority of respondents in both T2 (77.9 %) and T3 (85.4 %) surveys agreed that the EMR improved their ability to provide care more safely. CONCLUSIONS: Implementation of an EMR in a large primary care practice required redesign of many organizational processes, and was associated with improvements in safety culture. Most primary care providers agreed that the EMR allowed them to provide care more safely.

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“…In the meantime Italian Hospital Trusts have set up new public relations offices [Uffici di Relazione con il Pubblico (URP)], which, however, fail to go to the root of the problem which is primarily one of doctor-patient relations. [34]. On the other hand, Italian law regards the doctor-patient relation as a contract to be honoured.…”

Section: Why Communicate?mentioning

confidence: 99%

Doctor-patient communication in radiology: a great opportunity for future radiology

Bazzocchi

2012

Radiol med

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This text discusses several aspects of doctor-patient communication in radiology, including the origins, advantages, and ethical and legal aspects. Over the last 10 years, radiologists have assumed increasing responsibilities towards patients and society. Patients, who are becoming better informed and more aware about medical issues, have a right to be given a timely diagnosis and want to receive as much information as possible from the radiologist. This has implications for several levels of everyday radiological practice, including the organisation of work, legal and ethical aspects and radiologist training. Better interaction with the patient helps to build a closer, more trusting, relationship with the result that the radiologist will be more motivated in his or her work. Until now, radiologists were not adequately trained to communicate the diagnosis directly and verbally to patients, especially when the diagnosis was unfavourable. It is important to emphasise the need for more specific and practical training in this respect, which is indispensable for future developments of the discipline. Keywords Communication · Radiology · Physician-patient relations Introduction Genesis 1(3, 4): And God said "Let there be light…"The first verses of the Bible state that God "said" and that each phase of creation essentially came in to being through Riassunto

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Event Reporting to a Primary Care Patient Safety Reporting System: A Report From the ASIPS Collaborative

Cited by 130 publications

References 18 publications

Harm Resulting from Inappropriate Telephone Triage in Primary Care

Harm Resulting from Inappropriate Telephone Triage in Primary Care

Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

Doctor-patient communication in radiology: a great opportunity for future radiology

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