Document Detail


Comparing patient-reported hospital adverse events with medical record review: do patients know something that hospitals do not?
MedLine Citation:
PMID:  18626049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hospitals routinely survey patients about the quality of care they receive, but little is known about whether patient interviews can detect adverse events that medical record reviews do not. OBJECTIVE: To compare adverse events reported in postdischarge patient interviews with adverse events detected by medical record review. DESIGN: Random sample survey. SETTING: Massachusetts, 2003. PATIENTS: Recently hospitalized adults. MEASUREMENTS: By using parallel methods, physicians reviewed postdischarge interviews and medical records to classify hospital adverse events. RESULTS: Among 998 study patients, 23% had at least 1 adverse event detected by an interview and 11% had at least 1 adverse event identified by record review. The kappa statistic showed relatively poor agreement between interviews and medical records for occurrence of any type of adverse event (kappa = 0.20 [95% CI, 0.03 to 0.27]) and somewhat better agreement between interviews and medical records for life-threatening or serious events (kappa = 0.33 [CI, 0.20 to 0.45]). Record review identified 11 serious, preventable events (1.1% of patients). Interviews identified an additional 21 serious and preventable events that were not documented in the medical record, including 12 predischarge events and 9 postdischarge events, in which symptoms occurred after the patient left the hospital. LIMITATIONS: Patients had to be healthy enough to be interviewed. Delay in reaching patients (6 to 12 months after discharge) may have resulted in poor recall of events during the hospital stay. CONCLUSION: Patients report many events that are not documented in the medical record; some are serious and preventable. Hospitals should consider monitoring patient safety by adding questions about adverse events to postdischarge interviews.
Authors:
Joel S Weissman; Eric C Schneider; Saul N Weingart; Arnold M Epstein; Joann David-Kasdan; Sandra Feibelmann; Catherine L Annas; Nancy Ridley; Leslie Kirle; Constantine Gatsonis
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  149     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-15     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  100-8     Citation Subset:  AIM; IM    
Affiliation:
Institute for Health Policy, Massachusetts General Hospital, Harvard School of Public Health, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. joel.weissman@state.ma.us
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cross Infection / etiology
Disclosure
Female
Hospitals / standards*
Humans
Interviews as Topic
Male
Medical Audit*
Medical Errors
Medical Records / standards*
Middle Aged
Patient Discharge
Patients*
Postoperative Complications
Quality of Health Care*
Grant Support
ID/Acronym/Agency:
U18 HS11928/HS/AHRQ HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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