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Patient Safety and Quality

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Patient complaints about poor coordination of care or other services may help identify patient safety hazards

Patients who are victims of a medical error or adverse event are more likely to complain about their care. In similar fashion, care complaints may be a tip-off that the patient has suffered an adverse event or medical error, suggests a new study. It found that a patient-reported deficiency in service quality (especially poor coordination of care, poor interpersonal skill, and unprofessional behavior) more than doubled the odds of finding evidence of an adverse event, close call, or low- risk error on review of the patient's hospital chart.

As attentive observers of care, patients may be particularly well-positioned to observe the types of lapses that could lead to errors that could harm them. Thus, listening carefully to patients' complaints of care service quality problems may help identify patient safety hazards, suggest the Massachusetts researchers. They interviewed 228 patients during and after hospital admission regarding problems they experienced during their hospitalizations in order to identify service quality deficiencies: lack of respect for patient needs and preferences, waits and delays, poor communication, environmental issues and amenities, poor coordination of care, poor interpersonal skill, and unprofessional behavior.

Of the 52 incidents identified on chart review, patients experienced 34 adverse events, 11 close calls, and 7 low-risk errors. Any service quality deficiency more than doubled the odds of any of these. Service quality deficiencies involving poor coordination of care more than quadrupled the odds of adverse events and medical errors. The study was supported in part by the Agency for Healthcare Quality and Research (HS11644).

See "Do medical inpatients who report poor service quality experience more adverse events and medical errors?" by Benjamin B. Taylor, M.D., M.P.H., Edward R. Marcantonio, M.D., M.Sc., Odelya Pagovich, M.D., and others, in the February 2008 Medical Care 46(2), pp. 224-228.

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