Patient safety is one of the key goals assigned a top priority by healthcare. However, medical errors and adverse events remain and threaten patients. To understand the given topic in an in-depth manner, it is essential to identify differences between a medical error and an adverse event as part of healthcare quality. While it seems that the latter is a consequence of the former, some definitions need to be clarified.
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Reviewing the book by Joshi, Ransom, Nash, and Ransom (2014), it is possible to note that an adverse event is identified as any injury or harm received by a patient as a result of medical intervention. In some cases, adverse events may be caused by errors, which can be regarded as preventable. However, an adverse event may occur even if the medical intervention was planned and thoroughly prepared, since the human body may react differently.
Some scholars consider such cases as the ones that cannot be classified as adverse, suggesting calling them complications or potential health risks. Others believe that unintended ham, be it injury or any side effect, should be associated with an adverse event.
In spite of the ambiguous approach to the definition of an adverse event in medical practice, it is evident that patients feel uncomfortable during such cases. More to the point, harm may be inevitable. For example, patients with cancer receiving chemotherapy are likely to suffer from vomiting or nausea, and that is not the adverse event, since the mentioned treatment is usually associated with such complications. Even though the research allowed decreasing them significantly, some of chemotherapy complications remain unpreventable.
A medical error refers to incorrect drug administration, therapy, intervention, and any other prescription made by a doctor. The concept of culpability is the key to determine whether it is a medical error or not. In particular, a medical error implies that some sequence of the actions of a health worker worsened a patient’s condition or resulted in his or her death, thus failing to achieve the intended health outcome (Joshi et al., 2014).
In medicine, there is also a classification of errors, including diagnostic, planning, and execution. The causes of errors are divided into objective and subjective. An example of an objective cause is the atypical course of a patient’s illness, for example, allergic reactions. The subjective reason for a medical error is, for example, a lack of experience in managing a patient, improper behavior of medical personnel, or inadequate documentation.
As a rule, it is a failure of the system that leads to medical errors, yet a person responsible for the patient experienced the adverse event is to blame. Such an approach cannot contribute to the system improvement. Elaborated by the Agency for Healthcare Research and Quality (AHRQ), the Patient Safety Indicators software allows measuring the actions and intentions of a doctor. It is also suggested to apply teamwork and crew resource management (CRM) to ensure patient safety. For example, in case of the collaborative actions of a physician and a nurse, the latter may detect the improper dosage of drug prescribed by the former and prevent an adverse event by reporting. In general, to handle adverse events, it is essential to encourage a reporting initiative and apply technology along with design safety processes.
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To conclude, an adverse event is a harm experienced by a patient as a result of a medical error, and this is the key difference between them. In case of some interventions, harm is inevitable. To cope with medical errors and adverse events, it is important to focus on patient safety initiatives.
Joshi, S. M., Ransom, E. R., Nash, D. B., & Ransom, S. B. (Eds.). (2014). The healthcare quality book: Vision, strategy, and tools (3rd ed.). Chicago, IL: Health Administration Press.