A medical error is a preventable adverse effect of care ("iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailments. The incidence of medical errors varies depending on the setting. The World Health Organization has named adverse outcomes due to patient care that is unsafe as the 14th causes of disability and death in the world, with an estimated 1/300 people being potentially harmed by healthcare practices around the world.
Definitions A medical error occurs when a health-care provider chooses an inappropriate method of care or improperly executes an appropriate method of care. Medical errors are often described as "human errors in healthcare". There are many types of medical error, from minor to major, and causality is often poorly determined. There are many taxonomies for classifying medical errors.
Definitions of diagnostic error Defining diagnostic error is important for measuring its frequency, identifying its causes, and implementing strategies to reduce harm, steps that are essential for improving patient safety. The complexity of diagnosis as both a process (the act of arriving at a diagnosis) and a label (the name of the assigned disease) has led to multiple, overlapping definitions and there is no single definition of diagnostic error. Diagnostic error with regard to labels has been defined by Graber et al. as a diagnosis that is wrong, egregiously delayed, or missed altogether. This error can only be applied in retrospect, using some gold standard (for example, autopsy findings or a definitive laboratory test) to confirm the correct diagnosis. Diagnostic error with regard to processes has been defined by Schiff et al. as any breakdown in the diagnostic process, including both errors of omission and errors of commission, and by Singh et al. as a "missed opportunity" in the diagnostic process, based on retrospective review. In its landmark report, Improving Diagnosis in Health Care, The National Academy of Medicine proposed a new, hybrid definition that includes both label- and process-related aspects: "A diagnostic error is failure to establish an accurate and timely explanation of the patient's health problem(s) or to communicate that explanation to the patient." This is the only definition that specifically includes the patient in the definition wording.
Definition of prescription error A prescription or medication error, as defined by the National Coordinating Council for Medication Error Reporting and Prevention, is an event that is preventable that leads to or has led to unsuitable use of medication or has led to harm to the person during the period of time that the medicine is controlled by a clinician, the person, or the consumer. Some adverse drug events can also be related to medication errors.
Impact One study suggests that 180,000 people die each year partly as a result of iatrogenic injury. This appears to be increasing - for example, the World Health Organization registered 14 million new cases and 8.2 million cancer-related deaths in 2012, and estimated that the number of cases could increase by 70% through 2032. As the number of cancer patients receiving treatment increases, hospitals around the world are seeking ways to improve patient safety, to emphasize traceability and raise efficiency in their cancer treatment processes. Children are often more vulnerable to a negative outcome when a medication error occurs as they have age-related differences in how their bodies absorb, metabolize, and excrete pharmaceutical agents. One study reported that approximately 6.9% to 14.5% of pediatric patients were prescribed inappropriate medications secondary to diagnostic inaccuracies. A 2019 study reported that pediatric emergency departments are susceptible to medication errors due to weight-based dosing calculations, prescribing inaccuracies, and challenges within communication which contributed to inappropriate mediation administration in children.
UK In the UK, an estimated 850,000 medical errors occur each year, costing over £2 billion (estimated in the year 2000). The accuracy of this estimate is not clear. Criticism has included the statistical handling of measurement errors in the report, significant subjectivity in determining which deaths were "avoidable" or due to medical error, and an erroneous assumption that 100% of patients would have survived if optimal care had been provided.
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