A study in the Journal of the American Medical Association (JAMA) may change the way the medical community views outpatient care. While the dangers associated with inpatient medicine have been explored for several years, the JAMA study is the first to give the same scrutiny to the quality of outpatient medical care.
Weill Cornell Medical College researchers looked at data on the amount of medical malpractice claims that were paid in 2009 and found that 52 percent of these payments were the result of errors made during outpatient care. While this does not represent all of the medical mistakes that were made that year in an outpatient setting, the study is a good indicator of the seriousness of the problem.
"There were a remarkably high number of cases in the outpatient setting, and the outcomes weren't trivial," lead researcher Tara Bishop told The Washington Post.
Causes of Outpatient Medical Errors
There are several factors that contribute to errors made during outpatient care. One of the main reasons for these mistakes is the fact that doctors are trying to do more tasks in less time. As care has shifted from hospitals to outpatient care facilities, medical personnel have been stretched to their limits - and as a result, sometimes medical diagnoses fall through the cracks. Doctors pressed to see a number of patients in a limited timeframe are sometimes overlooking key lab reports that may result in critical errors such as a missed diagnosis of cancer.
These busy schedules have contributed to another factor causing outpatient care mistakes: lack of communication between medical professionals. In a statement, Bishop explained it this way: "A primary care physician may refer a patient to a specialist, but the actual appointment may never happen. A cardiologist may order a scan, unaware that it was already performed during a patient's hospital stay." Problems with physician communication led in some instances to medication errors that resulted in adverse drug interactions and surgeries performed on either the wrong site or the wrong person.
How to Remedy Mistakes in Outpatient Care
In order to help improve the level of care that patients receive in outpatient settings - and decrease the amount of errors - Bishop said that communication must be treated like a priority. To that end, one remedy would be to increase the amount of communication between medical professionals. Another way to improve outpatient care is to use technologies - like electronic medical records - designed to make patient information more accessible to medical personnel.
Source: WSJ.com, "Time to Focus on Medical Errors Outside the Hospital," Katherine Hobson, 14 June 2010
