Epidemiology of medical errors

First, a methodological study examined the application of epidemiology to the study of medical errors. This study proposed that epidemiologic methods would be useful as a tool to determine rates, risks, prevalence, or incidence of adverse health outcomes as a result of medical care. The study examined a definition in measurement of patient safety events, data collection methods, and the study designs that may be useful for studying medical errors.; The second study explored variables associated with increased reporting of safety events, a key factor associated with improved safety in other industries. This study examined the association between data from a survey of employees on the culture of safety and actual reporting rates of errors at a group of hospitals. The results indicated that reporting of near misses (errors caught before they reach the patient) was important in driving the overall culture for reporting of safety events. Departments that responded in the survey that they often report near misses also had higher overall reporting of safety events.; The third study examined risk factors for insulin medication errors using a cohort study and a nested case-control study. The source population was all inpatients with orders for insulin at four Twin Cities hospitals from 2000–2001. Cases were patients with insulin errors and controls were patients without errors. For the nested case-control study, controls were matched in a 1:1 ratio to cases on hospital, age, gender, diagnosis, and severity of illness. There were 404 cases and 404 matched controls. Results of the case-control study indicated several modifiable risk factors, such as insulin order complexity, and results of the cohort study indicated several non-modifiable risk factors, such as gender or diagnosis, were significantly associated with insulin errors.