Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I
BMJ Quality & SafetyPublished 1 April 2004Open access
Troyen A. Brennan
Citations943
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TL;DR
There is a substantial amount of injury to patients from medical management, and many injuries are the result of substandard care.
Abstract
There is a substantial amount of injury to patients from medical management, and many injuries are the result of substandard care.
Keywords
Health Professions
New England Journal of MedicineIncidence of Adverse Events and Negligence in Hospitalized Patients
4,666 Citations1991Troyen A. Brennan, Lucian L. Leape +7 more
The incidence of adverse events, defined as injuries caused by medical management, and of the subgroup of such injuries that resulted from negligent or substandard care, in New York State in 1984 were estimated.
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Adverse drug events were common and often preventable; serious ADEs were more likely to be preventable and prevention strategies should target both stages of the drug delivery process.
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Physician computer order entry decreased the rate of nonintercepted serious medication errors by more than half, although this decrease was larger for potential ADEs than for errors that actually resulted in an ADE.
BMJAdverse events in British hospitals: preliminary retrospective record review
2,074 Citations2001Charles Vincent, Graham Neale +1 more
These results suggest that adverse events are a serious source of harm to patients and a large drain on NHS resources.
Medical CareIncidence and Types of Adverse Events and Negligent Care in Utah and Colorado
1,671 Citations2000Eric J. Thomas, David M. Studdert +7 more
The incidence and types of adverse events in Utah and Colorado in 1992 were similar to those in New York State in 1984 and improving systems of surgical care and drug delivery could substantially reduce the burden of iatrogenic injury.
Italian Journal of Public HealthTo err is human. Building a safer health system
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The IOM report “To Err is Human” proposes an approach for reducing medical errors and improving patient safety by designing processes that are able to ensure that patients are safe from accidental injury.
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462 Citations2003Eric J. Thomas, Laura A. Petersen
8 methods used to measure errors and adverse events in health care and their strengths and weaknesses are identified and a general framework to help health care providers, researchers, and administrators choose the most appropriate methods to meet their patient safety measurement goals is proposed.
BMJ Quality & SafetyIncidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I
451 Citations2004Troyen A. Brennan
BMJComparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals
372 Citations2004Philippe Michel, Jean Luc Quenon +2 more
The prospective method of data collection may be more appropriate for epidemiological studies that aim to convince clinical teams that their errors contribute significantly to adverse events, to study organisational and human factors, and to assess the impact of risk reduction programmes.
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210 Citations1989Howard H. Hiatt, Benjamin A. Barnes +10 more
For nearly two decades, an atmosphere of crisis has enveloped the authors' system of medical-malpractice litigation and liability insurance, and legislators have responded to the problems of a shrinking insurance market and rising insurance costs by restricting liability and, in some cases, limiting damages.
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168 Citations2001David M. Studdert, Troyen A. Brennan
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The majority of adverse events and episodes of negligent care are discoverable with the methods used to evaluate medical records, and the adverse events the authors failed to discover led to less costly malpractice claims.
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161 Citations2000E. J THOMAS
Five methodological differences accounted for some of the discrepancy between the two studies and the remaining three-fold disparity are that quality of care was worse in Australia and that medical record content and/or reviewer behaviour was different.
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148 Citations1989Troyen A. Brennan, R J Localio +1 more
It was found that a two-step review process of medical records can produce judgments about adverse events that are both reliable and valid, and cases classified as difficult to judge from causation were judged less reliable.
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119 Citations2000W. B. Runciman
It is hypothesize that this disparity is due to different thresholds for admission and discharge and to a greater degree of under-reporting of certain types of problems as AEs by UTCOS than QAHCS reviewers.
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104 Citations2001Peter Davis, Roy Lay‐Yee +5 more
Although the data generated by a feasibility study must be treated with caution, the pattern of results is consistent with comparable Australian findings and is of potential clinical and managerial significance.
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68 Citations2004Knight Steel
Given the increasing number and complexity of diagnostic procedures and therapeutic agents, monitoring of untoward events is essential, and attention should be paid to educational efforts to reduce the risks of iatrogenic illness.
Choice Reviews OnlineJust doctoring: medical ethics in the liberal state
30 Citations1992
Troyen Brennan offers clinical examples of many of today's most challenging medical problems from informed consent to care rationing and the repercussions of the HIV epidemic and gives his recommendation for a new ethical perspective.
PubMedAdverse events regional feasibility study: methodological results.
24 Citations2001Peter Davis, Roy Lay-Yee +5 more
Research into the occurrence, causation and prevention of AEs in New Zealand health care settings is methodologically feasible and meets international benchmark standards.
Yale Law School Legal Scholarship RepositoryModern Tort Law and Its Reform
12 Citations1987George L. Priest
Survey of AnesthesiologyThe High Cost of Low-Frequency Events. The Anatomy and Economics of Surgical Mishaps
10 Citations1982Nathan P. Couch, Nicholas L. Tilney +2 more
A one-year prospective survey to identify adverse outcomes due to error during care in the field of general surgery found 36 cases among 5612 surgical admissions to the Peter Bent Brigham Hospital; in 23 cases the initiating mishap had occurred in another hospital before transfer.