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J Formos Med Assoc. 2016 Jun;115(6):434-9. doi: 10.1016/j.jfma.2015.11.004. Epub 2016 Mar 21.

Epidemiology of medical adverse events: perspectives from a single institute in Taiwan.

Author information

1
Quality Management Center, Cathay General Hospital, Taipei, Taiwan; Medical Intensive Care Unit, Cathay General Hospital, Taipei, Taiwan; Graduate Institute of Translational and Interdisciplinary Medicine, National Central University, Taoyuan, Taiwan.
2
Ministry of Health and Welfare, Taipei, Taiwan.
3
Quality Management Center, Cathay General Hospital, Taipei, Taiwan.
4
Quality Management Center, Cathay General Hospital, Taipei, Taiwan; Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan.
5
Department of Medical Research, Cathay General Hospital, Taipei, Taiwan.
6
Outcome Research Unit, Cathay Medical Research Institute, Cathay General Hospital, Taipei, Taiwan.
7
Quality Management Center, Cathay General Hospital, Taipei, Taiwan; Outcome Research Unit, Cathay Medical Research Institute, Cathay General Hospital, Taipei, Taiwan; Department of Otolaryngology, Cathay General Hospital, Taipei, Taiwan; Fu Jen Catholic University School of Medicine, New Taipei City, Taiwan. Electronic address: drtony@seed.net.tw.

Abstract

BACKGROUND/PURPOSE:

Epidemiology data of medical adverse events (MAEs) are crucial for patient safety policymaking. However, no epidemiological data on MAE exist in Taiwan. In this study, we aimed to investigate the incidence of MAEs at a major medical center in northern Taiwan.

METHODS:

The Harvard Medical Practice Study methodology was modified using a criterion-based screening algorithm and critical medical record review process to investigate the risks and incidences of MAEs. A Criterion-Based Screening for Medical Adverse Events (CBSMAE) checklist was developed, and a three-tier strategy was applied to screen and review 2007 inpatient hospitalizations from a single institution.

RESULTS:

A total of 2934 charts was sampled (Tier 1) and 950 possible MAEs were identified (Tier 2). One hundred and sixty-one probable MAE cases were subsequently critically reviewed (Tier 3). Nineteen (0.7%) MAE cases were confirmed. The MAEs involved 10 women and nine men (mean age, 70 years). Most MAEs were from the surgery department [11 (57.9%) patients]. The major admission diagnoses were cardiac diseases [7 (36.8%) patients] with a cardiac problem [13 (31.7%) patients] as the major comorbidity. Major MAE attributes were a staff technique problem [12 (46.2%) patients] and patients' underlying conditions (likelihood rating, 2.2). Eight (42.1%) patients required additional medical management, four (21.1%) patients had a disability, and five (26.3%) patients had in-hospital mortality. Night MAEs (47.4%) were considered preventable.

CONCLUSION:

Surgical patients with cardiac conditions were at risk of MAE, particularly patients who received invasive procedures. The epidemiology information from this study can serve as baseline data to monitor a patient safety improvement campaign.

KEYWORDS:

epidemiology; medical adverse event

PMID:
27013109
DOI:
10.1016/j.jfma.2015.11.004
[Indexed for MEDLINE]
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