Davis Joshua, Bittner-Fagan Heather, Savoy Margot
Sidney Kimmel Medical College - Thomas Jefferson University, 1025 Walnut St, Philadelphia, PA 19107.
The Family Medicine Center-Wilmington, 1400 N Washington Street 3rd Floor, Wilmington, Delaware 19801.
FP Essent. 2017 Dec;463:11-15.
Medical errors are common and can lead to patient harm and death. Most research on errors has focused on inpatient care, yet errors are at least as common in the outpatient setting and likely are underreported. Common types of errors in the outpatient setting are diagnostic, drug, and testing errors. The most effective specific interventions for reducing errors in the outpatient setting remain unknown. Considering the current lack of data, the authors recommend a quality improvement approach to understanding local factors in patient safety. Appropriate education and training of all staff members in their roles in patient safety is an important aspect of any program to reduce errors, though these measures rarely are sufficient on their own. Creation of a culture of safety, use of adequate systems and policies for reporting and identifying errors, and use of technologies to prevent errors also are important.
医疗差错很常见，可能导致患者伤害甚至死亡。大多数关于差错的研究都集中在住院治疗方面，然而差错在门诊环境中至少同样常见，而且很可能报告不足。门诊环境中常见的差错类型包括诊断、用药和检查错误。目前仍不清楚在门诊环境中减少差错最有效的具体干预措施是什么。鉴于目前缺乏数据，作者建议采用质量改进方法来了解患者安全方面的当地因素。对所有工作人员进行与其在患者安全中所扮演角色相关的适当教育和培训，是任何减少差错计划的一个重要方面，不过这些措施单靠自身很少能充分发挥作用。营造安全文化、使用适当的系统和政策来报告和识别差错，以及利用技术来预防差错也很重要。
