Many medical injuries are preventable, but there are few reported successful strategies to prevent such injuries.
Previous work identified coverage by house staff not primarily responsible for the patient (cross-coverage) as a significant correlate of risk for preventable adverse events.
A four-month intervention - computerized sign-outswas introduced in 1993 in an urban teaching hospital to improve continuity of care during cross-coverage and thereby reduce risk for preventable adverse events.
A previously tested confidential self-report system was used to identify adverse events, which were defined as unexpected complications of medical therapy that resulted in increased length of stay or disability at discharge.
A panel of three board-certified internists confirmed events and evaluated preventability based on case summaries.
After the intervention, the rate of preventable adverse events among the 3 747 patients admitted to the medical service decreased from 1.7% to 1.2% (p<0.10).
Both univariate and multivariate analysis revealed no association between cross coverage and preventable adverse events after the intervention.
In the baseline period, the odds ratio (OR) for a patient suffering a preventable adverse event during cross coverage was 5.2 (95% confidence interval [CI], 1.5-18.2 ; p=0.01), but was no longer significant after the intervention (OR, 1.5 ; 95% CI, 0.2-9.0). (...)
Mots-clés Pascal : Hôpital, Traitement, Documentation, Soin, Iatrogène, Banque donnée, Stockage information, Qualité
Mots-clés Pascal anglais : Hospital, Treatment, Documentation, Care, Iatrogenic, Databank, Information storage, Quality
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 21/07/1998.