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Ottawa Hospital Patient Safety Study: incidence and timing of adverse events in patients admitted to a Canadian teaching hospital.

https://arctichealth.org/en/permalink/ahliterature180609
Source
CMAJ. 2004 Apr 13;170(8):1235-40
Publication Type
Article
Date
Apr-13-2004
Author
Alan J Forster
Tim R Asmis
Heather D Clark
Ghiath Al Saied
Catherine C Code
Sharon C Caughey
Kevin Baker
James Watters
Jim Worthington
Carl van Walraven
Author Affiliation
Ottawa Health Research Institute, Ottawa, Ont. aforster@ohri.ca
Source
CMAJ. 2004 Apr 13;170(8):1235-40
Date
Apr-13-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Ambulatory Care - standards
Hospitals, Teaching - standards - utilization
Humans
Iatrogenic Disease - epidemiology
Incidence
Medical Errors - statistics & numerical data
Middle Aged
Ontario - epidemiology
Safety Management - standards - statistics & numerical data
Time Factors
Abstract
Adverse events are poor patient outcomes that are due to medical care. Studies of hospital patients have demonstrated that adverse events are common, but few data describe the timing of them in relation to hospital admission. We evaluated characteristics of adverse events affecting patients admitted to a Canadian teaching hospital, paying particular attention to timing.
We randomly selected 502 adults admitted to the Ottawa Hospital for acute care of nonpsychiatric illnesses over a 1-year period. Charts were reviewed in 2 stages. If an adverse event was judged to have occurred, a physician determined whether it occurred before or during the index hospitalization. The reviewer also rated the preventability, severity and type of each adverse event.
Of the 64 patients with an adverse event (incidence 12.7%, 95% confidence interval [CI] 10.1%-16.0%), 24 had a preventable event (4.8%, 95% CI 3.2%-7.0%), and 3 (0.6%, 95% CI 0.2%-1.7%) died because of an adverse event. Most adverse events were due to drug treatment, operative complications or nosocomial infections. Of the 64 patients, 39 (61%, 95% CI 49%-72%) experienced the adverse event before the index hospitalization.
Adverse events were common in this study. However, only one-third were deemed avoidable, and most occurred before the hospitalization. Interventions to improve safety must address ambulatory care as well as hospital-based care.
Notes
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Cites: BMJ. 2001 Mar 3;322(7285):517-911230064
Cites: Ann Intern Med. 2002 Jun 4;136(11):812-612044129
Cites: Med J Aust. 1995 Nov 6;163(9):458-717476634
Cites: N Engl J Med. 1991 Feb 7;324(6):370-61987460
Comment In: CMAJ. 2004 Sep 14;171(6):549; author reply 550, 55215367443
Comment In: CMAJ. 2004 Sep 14;171(6):549-50; author reply 550, 55215367444
PubMed ID
15078845 View in PubMed
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Results of a pilot study reviewing dermatitis claims submitted to the Ontario Workplace Safety and Insurance Board.

https://arctichealth.org/en/permalink/ahliterature197159
Source
J Cutan Med Surg. 2000 Jul;4(3):117-20
Publication Type
Article
Date
Jul-2000
Author
D L Holness
Author Affiliation
Department of Occupational Health, St Michael's Hospital, 30 Bond St, Toronto, ON Canada.
Source
J Cutan Med Surg. 2000 Jul;4(3):117-20
Date
Jul-2000
Language
English
Publication Type
Article
Keywords
Adult
Decision Making
Dermatitis, Occupational - economics - epidemiology - etiology
Humans
Insurance Claim Review - statistics & numerical data
Ontario - epidemiology
Pilot Projects
Retrospective Studies
Safety Management - standards - statistics & numerical data
Workers' Compensation - statistics & numerical data
Workplace - standards - statistics & numerical data
Abstract
Workers who develop occupational skin disease are often eligible for workers' compensation benefits; however, there is little known about the decision-making process for adjudicating claims submitted for work-related skin problems.
The objective of this pilot study was to test a file abstraction instrument and determine the nature of information that was available for decision-making.
Files submitted to the Ontario Workplace Safety and Insurance Board (WSIB) in 1995 for dermatitis were identified. The last 51 files were abstracted to collect information concerning demographics, physicians seen, information available in the claim file for decision making, as well as type of claim and outcome of the claim.
Approximately 70% of the claims were "no-lost-time" and one-third of total claims were accepted for compensation. Although there was reasonable information related to the clinical status, most claims had no information that related to workplace issues such as exposures or association with work. Claims that were for lost time or were accepted had more information available.
The pilot study has demonstrated that there is a lack of information related to workplace issues that would be important in decision-making. The study will be extended to examine the entire year's claims in order to develop a strategy to enhance the understanding of the WSIB and providers regarding the information necessary for decision-making and to determine methods to facilitate its collection.
PubMed ID
11003714 View in PubMed
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