PMID- 16344418
OWN - NLM
STAT- MEDLINE
DCOM- 20060112
LR  - 20220408
IS  - 0003-9926 (Print)
IS  - 0003-9926 (Linking)
VI  - 165
IP  - 22
DP  - 2005 Dec 12-26
TI  - Residents report on adverse events and their causes.
PG  - 2607-13
AB  - BACKGROUND: Resident physicians are frontline providers with a unique vantage 
      point from which to comment on patient safety-related events. METHODS: We 
      surveyed trainees at 2 teaching hospitals about experiences with adverse events 
      (AEs), mistakes, and near misses, as well as the potential causes. RESULTS: 
      Responses were obtained from 821 (57%) of 1440 eligible trainees. Analysis was 
      restricted to 689 clinical trainees. More than half (55%) reported ever caring 
      for a patient who had an AE. The most common types of AEs were procedural and 
      medication related. More than two thirds of AEs were considered significant. Of 
      the most recent AEs, 24% were attributed to mistakes. The most common reasons for 
      mistakes, as perceived by residents, were excessive work hours (19%), inadequate 
      supervision (20%), and problems with handoffs (15%). In the last week, 114 
      respondents (18%) reported having a patient with an AE; of these, 42 (37%) 
      reported AEs involving a mistake for which they considered themselves 
      responsible. In addition, 141 (23%) reported near-miss incidents in the last week 
      for which they considered themselves responsible. In multivariate analyses, 
      significant predictors of AEs in the last week were inpatient rotation, duty 
      hours in the last week, and procedural specialty. Predictors of near-miss errors 
      in the last week were inpatient rotation, days of fatigue in the last month, and 
      postgraduate year 1 status. CONCLUSIONS: These findings support the perception 
      that AEs are commonly encountered by physicians and often associated with errors. 
      Causes of errors in teaching hospitals appear to be multifactorial, and a variety 
      of measures are necessary to improve safety. Eliciting residents' perspectives is 
      important because residents may perceive events, actions, and causal 
      relationships that medical record reviewers or observers cannot.
FAU - Jagsi, Reshma
AU  - Jagsi R
AD  - Department of Radiation Oncology, and Institute for Health Policy, Massachusetts 
      General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
FAU - Kitch, Barrett T
AU  - Kitch BT
FAU - Weinstein, Debra F
AU  - Weinstein DF
FAU - Campbell, Eric G
AU  - Campbell EG
FAU - Hutter, Matthew
AU  - Hutter M
FAU - Weissman, Joel S
AU  - Weissman JS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Intern Med
JT  - Archives of internal medicine
JID - 0372440
SB  - IM
CIN - Arch Intern Med. 2005 Dec 12-26;165(22):2561-2. PMID: 16344409
CIN - Arch Intern Med. 2006 Jul 10;166(13):1422-3; author reply 1424-5. PMID: 16832014
CIN - Arch Intern Med. 2006 Jul 10;166(13):1423; author reply 1423-5. PMID: 16832016
MH  - Fatigue/complications
MH  - Female
MH  - Hospitals, Teaching
MH  - Humans
MH  - *Internship and Residency
MH  - Male
MH  - Massachusetts
MH  - Medical Errors/*statistics & numerical data
MH  - Medicine/statistics & numerical data
MH  - Personnel Staffing and Scheduling
MH  - Specialization
MH  - Specialties, Surgical/statistics & numerical data
MH  - Surveys and Questionnaires
MH  - Workload
EDAT- 2005/12/14 09:00
MHDA- 2006/01/13 09:00
CRDT- 2005/12/14 09:00
PHST- 2005/12/14 09:00 [pubmed]
PHST- 2006/01/13 09:00 [medline]
PHST- 2005/12/14 09:00 [entrez]
AID - 165/22/2607 [pii]
AID - 10.1001/archinte.165.22.2607 [doi]
PST - ppublish
SO  - Arch Intern Med. 2005 Dec 12-26;165(22):2607-13. doi: 
      10.1001/archinte.165.22.2607.