PMID- 30071794
OWN - NLM
STAT- MEDLINE
DCOM- 20191018
LR  - 20200225
IS  - 1557-9700 (Electronic)
IS  - 1075-2730 (Print)
IS  - 1075-2730 (Linking)
VI  - 69
IP  - 10
DP  - 2018 Oct 1
TI  - Predictors of Adverse Events and Medical Errors Among Adult Inpatients of 
      Psychiatric Units of Acute Care General Hospitals.
PG  - 1087-1094
LID - 10.1176/appi.ps.201800110 [doi]
AB  - OBJECTIVE: The aim of this study was to identify factors associated with the 
      occurrence of adverse events (AEs) or medical errors (MEs) during inpatient 
      psychiatric hospitalizations. METHODS: A full-probability random sample of 4,371 
      charts from 14 inpatient psychiatric units at acute care general hospitals in 
      Pennsylvania were reviewed in a two-stage process that comprised screening and 
      flagging by nurses followed by review by psychiatrists. AE and ME rates were 
      calculated overall and then stratified by patient and hospital factors. 
      Unadjusted and adjusted logistic regression models examined predictors of AEs and 
      MEs. RESULTS: An AE was identified in 14.5% of hospitalizations (95% confidence 
      interval [CI]=11.7-17.9), and an ME was identified in 9.0% (CI=7.5-11.0). In 
      adjusted analyses, patients with a longer length of stay and older patients had 
      higher odds of experiencing an AE or an ME. Patients ages 31-42 (compared with 
      ages 18-30), with commercial insurance (compared with Medicare or Medicaid or 
      uninsured), or treated at high-volume hospitals (compared with low, medium, or 
      very high) had lower odds of an AE. Patients age 54 or older (compared with ages 
      18-30), admitted during the weekend, admitted to rural hospitals (compared with 
      urban), or treated at very-high-volume hospitals (compared with high) were more 
      likely to experience an ME. CONCLUSIONS: This study provides insight into factors 
      that put patients and hospitals at increased risk of patient safety events. This 
      information can be used to tailor improvement strategies that enhance the safety 
      of patients treated on general hospital psychiatric units.
FAU - Vermeulen, Jentien M
AU  - Vermeulen JM
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - Doedens, Paul
AU  - Doedens P
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - Cullen, Sara W
AU  - Cullen SW
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - van Tricht, Mirjam J
AU  - van Tricht MJ
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - Hermann, Richard
AU  - Hermann R
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - Frankel, Martin
AU  - Frankel M
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - de Haan, Lieuwe
AU  - de Haan L
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
FAU - Marcus, Steven C
AU  - Marcus SC
AD  - Dr. Vermeulen, Mr. Doedens, Dr. van Tricht, and Dr. de Haan are with the 
      Department of Psychiatry, Academic Medical Center, University of Amsterdam, the 
      Netherlands. Dr. Cullen and Dr. Marcus are with the School of Social Policy and 
      Practice, University of Pennsylvania, Philadelphia. Dr. Hermann is with the 
      Institute for Clinical Research and Health Policy Studies, Tufts School of 
      Medicine, Tufts Medical Center, Boston. Dr. Frankel is with the Zicklin School of 
      Business, Baruch College, City University of New York, New York.
LA  - eng
GR  - R01 MH086722/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20180803
PL  - United States
TA  - Psychiatr Serv
JT  - Psychiatric services (Washington, D.C.)
JID - 9502838
SB  - IM
CIN - Psychiatr Serv. 2018 Oct 1;69(10):1045. PMID: 30277441
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Cross-Sectional Studies
MH  - Female
MH  - Hospitals, General/*statistics & numerical data
MH  - Hospitals, High-Volume/*statistics & numerical data
MH  - Hospitals, Rural/*statistics & numerical data
MH  - Hospitals, Urban/*statistics & numerical data
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Medical Errors/*statistics & numerical data
MH  - Middle Aged
MH  - Patient Admission/*statistics & numerical data
MH  - Patient Safety/*statistics & numerical data
MH  - Psychiatric Department, Hospital/*statistics & numerical data
MH  - Retrospective Studies
MH  - Time Factors
MH  - Young Adult
PMC - PMC6697121
MID - NIHMS1511293
OTO - NOTNLM
OT  - Medical errors/patient safety
OT  - Mental health systems/hospitals
COIS- Disclosures Dr. X reports receipt of consulting fees from Allergan, Alkermes, 
      Johnson & Johnson, Sage, and Sunovion. The other authors report no financial 
      relationships with commercial interests.
EDAT- 2018/08/04 06:00
MHDA- 2019/10/19 06:00
PMCR- 2019/10/01
CRDT- 2018/08/04 06:00
PHST- 2018/08/04 06:00 [pubmed]
PHST- 2019/10/19 06:00 [medline]
PHST- 2018/08/04 06:00 [entrez]
PHST- 2019/10/01 00:00 [pmc-release]
AID - 10.1176/appi.ps.201800110 [doi]
PST - ppublish
SO  - Psychiatr Serv. 2018 Oct 1;69(10):1087-1094. doi: 10.1176/appi.ps.201800110. Epub 
      2018 Aug 3.