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The Adverse Event Scenario

Medical Outsourcing Can Help
According to research findings published in the
Patient Safety in Surgery journal, adverse
events (AEs) occurring
after operations must be
documented efficiently
and their severity
determined for hospitals
to correctly identify
needs for patient safety
and create specific
interventions to improve
the care. Fatigue seems
to be the major contributory factor of adverse
events folloing surgery or treatment and is a
result of human error in
medical intervention.
!uman errors can be
caused by systems
failures such as poor
management decisions,
poor communications,
insufficient resources,
poor staffing, poor
documentation, or a lac"
of safeguards and chec" points. #echnical
mista"es and the inability to deal ith the
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comple$ities or demands of the healthcare
system can also cause medical errors. %t has
been found that medical outsourcing of non&
core tas"s can help to a great e$tent.
The Adverse Events Statistics
#he study covered three hospitals in the
'idest that are part of an integrated
healthcare system. (ata as e$amined from
)**+ till )**, for the reported AE rates
covering ,+ categories hich ere classified
according to type, patient age and severity.
#he researchers discovered that of the -),.-/
hospitali0ations, at least a single surgical
procedure and one AE as reported in +.12 of
the hospitali0ations, hich amounted to 1,3+-
cases. #he mean AE rate among the surgical
procedure groups as -).- per 4***
hospitali0ations. %n surgical categories, though,
the AE rate as as high as 111.. per 4*** for
operations performed on the pericardium and
heart. AEs most commonly included care
management. 'edication events ere ne$t,
folloed by invasive procedures.
Electronic reporting systems have been
developed by healthcare facilities to identify
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and promptly report AEs hich eventually
leads to measures for improving patient safety.
#his study has been comprehensive in
analy0ing systematically the AE rate variations
in various "inds of surgery. %t has also
specifically identified particular AE types hich
are the most common in each of the surgical
categories. #he study also helps identify AE
category severity levels.

Fatigue the Primary Culprit
%t has been reported that fatigue is the reason
for over 4+** events that have been reported
to the PPSA (Pennsylvania Patient Safety
Authority). #hirty seven of these cases ere
adverse events, and four of these adverse
events also led to the death of the patients.
'ost of the fatigue related events ere caused
by errors in medication or mista"es in
connection ith any procedure. #he study also
discovered that nurses or"ing for more than
4).1 hours have a greater chance of incurring
fatigue because of hich mista"es could occur.
5ut PPSA also claims that efforts are also being
made to reduce the or"ing hours of nurses
and other medical staff, though deeper and
more e$tensive measures needed to be carried
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out as fatigue cannot be addressed by reducing
the or"ing hours alone.
How Fatigued Sta Pose Ma!or "is#
Fatigued medical staff, as in other industries,
could display features such as attention lapses,
problems ith focus, reduced motivation,
confusion, inefficient problem solving, memory
lapses, irritability, loss of empathy, flaed
communication, etc. Studies ith nurses
revealed that or"ing overtime or in 4)&hour
or" shifts could result in difficulties in
remaining aa"e and alert during duty hours.
#he ris" of errors is therefore three times
greater. 6or"ing 4).1 hours or more posed the
highest ris".
$rim "eminder o %hat Fatigue Could &o
A classic case of fatigue as reported of a
6isconsin&registered nurse in )**+. She as
charged ith class ! felony for mista"enly
administering an epidural medication to a
patient in place of the antibiotic prescribed. 7n
investigating the 6isconsin (epartment of
8egulation and 9icensing records, it emerged
that the nurse as on to consecutive eight&
hour shifts hich ended on the midnight of the
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day of the incident folloing hich she as
scheduled to join for the ne$t eight&hour shift
in the morning at . A'.
How Medical Outsourcing Can Help
Fatigue seems to be the major contributory
factor of adverse events folloing surgery or
treatment. 'uch of this can be avoided
through medical outsourcing o non'core
tas#s such as medical coding, billing, A:8
collections, forms processing, transcription,
and so on. 6ith a professional team handling
these tas"s, healthcare providers can focus
better on hat they do and avoid causing
unintentional harm to patients.