Potential prevention of medical errors in casualty surgery by using information technology

ABSTRACT

Recent studies on adverse events in medicine have shown that errors in medicine are not rare and may cause severe harm. Quality problems in discharge letters may be a source of medical error. We have analyzed 150 discharge letters of an outpaitient clinic for casualty surgery in order to identify and to classify typical mistakes. A Failure Mode and Effect Analysis has been initiated in order to estimate the risk associated with different failure types. Possible IT solutions to prevent the identified problems have been assessed, focusing on expected effects and on feasibility. Our analyses have shown that there is a need to improve the quality of discharge letters, and that IT support based on the frequency and severity of certain error types has a good potential. We plan to introduce both pre-structured discharge letters and reminders in order to prevent the observed errors. They could improve both documentation quality and, if used during the patient visit, quality of treatment. Moreover, they could produce training effects on less experienced physicians. To be able to rapidly integrate such an adapted IT support into a comprehensive Healthcare Information System (HIS), it is important to establish a responsive IT infrastructure.

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INDEX TERMS

Primary Classification:
  H. Information Systems
  H.1 MODELS AND PRINCIPLES
      H.1.2 User/Machine Systems

Additional Classification:
  J. Computer Applications
  J.3 LIFE AND MEDICAL SCIENCES

Keywords:
Failure Mode and Effect Analysis, demand driven system evolution, electronic discharge letters, medical error prevention, structured reporting