Patient safety in primary allied health care: What can we learn from incidents in a dutch exploratory cohort study?

Medical Care

Volumn 49, Issue 12, 2011, Pages 1089-1096

  Van Dulmen, Simone A ^a   Tacken, Margot A J B ^a   Staal, J Bart ^a   Gaal, Sander ^a   Wensing, Michel ^a   Nijhuis Van Der Sanden, Maria W G ^a  

^a RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

administration; adverse events; allied healthcare; patient records; patient safety

Indexed keywords

AGED; ARTICLE; FEMALE; HUMAN; INCIDENT REPORT; INTERPERSONAL COMMUNICATION; KINESIOTHERAPY; MAJOR CLINICAL STUDY; MALE; MEDICAL ERROR; MEDICAL RECORD REVIEW; NETHERLANDS; OCCUPATIONAL THERAPY; PARAMEDICAL DISCIPLINES; PATIENT MONITORING; PATIENT SAFETY; PHYSIOTHERAPY; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; RETROSPECTIVE STUDY; RISK ASSESSMENT; RISK FACTOR;

AGED; ALLIED HEALTH OCCUPATIONS; COMMUNICATION; FEMALE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH SERVICES RESEARCH; HUMANS; LOGISTIC MODELS; MALE; NETHERLANDS; PATIENT SAFETY; PRIMARY HEALTH CARE; PROSPECTIVE STUDIES; QUALITY OF HEALTH CARE; RETROSPECTIVE STUDIES; RISK FACTORS;

EID: 81355160325     PISSN: 00257079     EISSN: 15371948     Source Type: Journal    
DOI: 10.1097/MLR.0b013e3182367105     Document Type: Article

References (44)

1. Donaldson SL. An international language for patient safety. Global progress in patient safety requires classification of key concepts. Int J Qual Healthcare. 2009;21:1.
2. Zegers M, de Bruijne MC, Wagner C, et al. Design of a retrospective patient record study on the occurrence of adverse events among patients in Dutch hospitals. BMC Health Serv Res. 2007;7:27.
3. Hoonhout LHF, de Bruijne MC, Wagner C, et al. Direct medical costs of adverse events in Dutch hospitals. BMC Health Serv Res. 2009;9:27.
4. de Bruijne MC, Zegers M, Hoonhout LHF, et al. Onbedoelde schade in Nederlandse ziekenhuizen Dossieronderzoek van ziekenhuisopnames in 2004 [adverse events in Dutch hospitals Chart audit of hospital admissions in 2004]. Amsterdam/Utrecht: EMGO Instituut/NIVEL; 2007.
5. Wetzels R, Wolters R, van Weel C, et al. Harm caused by adverse events in primary care: a clinical observational study. J Eval Clin Pract. 2009;15:323-327.
6. Giesen P, Ferwerda R, Tijssen R, et al. Safety of telephone triage in GP cooperatives: do triage nurses correctly estimate urgency? Qual Saf Healthcare. 2007;16:181-184. (Pubitemid 46972860)
7. Sandars J, Esmail A. The frequency and nature of medical error in primary care: understanding the diversity across studies. Fam Pract. 2003;20:231-236. (Pubitemid 36722457)
8. Leeuw JRJ, de Veenhof C, Wagner C, et al. Patiëntveiligheid in de eerstelijnsgezondheidszorg: stand van zaken [patient safety in primary care: state of affairs]. Utrecht: NIVEL; 2008.
9. Sandstrom R. Malpractice by physical therapists: descriptive analysis of reports in the National Practitioner Data Bank public use data file, 1991-2004. J Allied Health. 2007;36:201-208.
10. Mu K, Lohman H, Scheirton L. Occupational therapy practice errors in physical rehabilitation and geriatrics settings: a national survey study. Am J Occup Ther. 2006;60:288-297. (Pubitemid 43886134)
11. Holla M, IJland M, van der Vliet A, et al. Overleden zuigeling na "craniosacrale" manipulatie van hals en wervelkolom [deceased infant after "craniosacral" manipulation of the neck and spine]. Ned Tijdschr Geneeskd. 2009;153:828-831.
12. Vohra S, Johnston B, Cramer K, et al. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics. 2007; 119:275-283.
13. Brand PLP, Engelbert RHH, Helders PJM, et al. Systematisch literatuuronderzoek naar de effecten van behandeling bij zuigelingen met "kopgewrichteninvloed bij storingen in de symmetrie" ("KISS-syndroom") [systematic review of the effects of therapy in infants with the KISS-syndrome (kinetic imbalance due to suboccipital strain)]. Ned Tijdschr Geneeskd. 2005;149:703-707. [OS]. (Pubitemid 40471081)
14. Carnes D, Mars TS, Mullinger B, et al. Adverse events and manual therapy: a systematic review. Man Ther. 2010;355-363.
15. Kerry R, Taylor AJ, Mitchell J, et al. Cervical arterial dysfunction and manual therapy: a critical literature review to inform professional practice. Man Ther. 2008;13:278-288.
16. Ernst E. Adverse effects of spinal manipulation: a systematic review. J R Soc Med. 2007;100:330-338. (Pubitemid 47104951)
17. Harmsen M, Gaal S, van Dulmen S, et al. Patient safety in Dutch primary care: study protocol. BMC Implement Sci. 2010;5:50.
18. Kolber M, Lucado AM. Risk management strategies in physical therapy: documentation to avoid malpractice. Int J Healthcare Qual Assur Inc Leadersh Health Serv. 2005;18:123-130. (Pubitemid 40754969)
19. Wetzels R, Wolters R, van Weel C, et al. Harm caused by adverse events in primary care: a clinical observational study. J Eval Clin Pract. 2009;15:323-327.
20. Michel P, Quenon JL, de Sarasqueta AM. Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals. BMJ. 2004;328:199.
21. Thomas EJ, Petersen LA. Measuring errors and adverse events in healthcare. J Gen Intern Med. 2003;18:61-67. (Pubitemid 36114967)
22. Wagner C, van der Wal G. Voor een goed begrip. Bevordering patiëntveiligheid vraagt om heldere definities [for a good understanding. Improving patient safety requires clear definitions]. Med Contact. 2005;60:1888-1891.
23. Gaal S, Verstappen W, Wensing M. Patient safety in primary care: a survey of general practitioners in the Netherlands. BMC Health Serv Res. 2010;10:21.
24. Peel MN. Epidemiology of falls in older age. Can J Aging. 2011;15:1-13.
25. Hartholt KA, van Beeck EF, Polinder S, et al. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. J Trauma. 2011;71:748-753.
26. Scuffham P, Chaplin S, Legood R. Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health. 2003;57:740-744. (Pubitemid 37059646)
27. van der Schaaf TW, Habraken MMP. PRISMA Method Medical Version A Brief Description. Eindhoven: Eindhoven University of Technology, Faculty of Technology Patient Safety Systems; 2005.
28. van Vuuren W, Shea CE, van der Schaaf TW. The Development of an Incident Analysis Tool for the Medical Field. Eindhoven: Eindhoven University of Technology; 1997.
29. Sherman H, Castro G, Fletcher M. Towards an international classification for patient safety: the conceptual framework. Int J Qual Healthcare. 2009;21:2-8.
30. Runciman W, Hibbert P, Thomson R, et al. Towards an international classification for patient safety: key concepts and terms. Int J Qual Healthcare. 2009;21:18-26.
31. Runciman WB, Baker GR, Michel P, et al. Tracing the foundations of a conceptual framework for a patient safety ontology. Qual Saf Healthcare. 2010;19:1-5.
32. Gaal S, Verstappen W, Wolters R, et al. Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study. Implement Sci. 2011;6:37.
33. Smits M, Huibers L, Kerssemeijer B, et al. Patient safety in out-of-hours primary care: a review of patient records. BMC Health Serv Res. 2010;10:335.
34. Mira JJ, Nebo C, Lorenzo S, et al. Patient report on information given, consultation time and safety in primary care. Qual Saf Healthcare. 2010;19:1-4.
35. Van Dulmen S, Schlief A, Oostendorp R, et al. Eindrapport Project Kwaliteitsindicatoren Fysiotherapie-3 (ProKwaF-3) Kwaliteit Fysiotherapeutische Verslaglegging [project quality indicators physical therapy: quality of documentation]. Nijmegen: IQ Healthcare; 2009.
36. Oostendorp R, Pluimers DJ, Nijhuis-van der Sanden MWG, et al. Fysiotherapeutische verslaglegging: de Achilleshiel voor Evidence-based Practice (EBP)? [Physical therapy patient documentation: the Achilles heel of evidence-based practice?]. Ned Tijdschr v Fysioth. 2006;116:56-61.
37. Bovens JAL, Pluimers DJ, Nijhuis-van der Sanden MWG, et al. Qualität der physiotherapeutischen Dokumentation in Patientenkrankenge-schichte [quality of physical therapy patient documentation]. Physi-oScience. 2009;5:114-123.
38. Elder NC, Dovey SM. Classification of medical errors and preventable adverse events in primary care: a synthesis of the literature. J Fam Pract. 2002;51:927-932. (Pubitemid 35291613)
39. Wilson T, Sheikh A. Enhancing public safety in primary care. BMJ. 2002;324:584-587. (Pubitemid 34214341)
40. Grol R, Wensing M, Eccles M. Improving Patient Care: The Implementation of Change in Clinical Practice. Oxford, United Kingdom: Elsevier; 2005.
41. Van der Wees PJ, Moore AP, Powers CM, et al, Development of clinical guidelines in physical therapy: perspective for international collaboration. Physical Therapy. Accepted July 2011.
42. Battles JB, Shea CE. A system of analyzing medical errors to improve GME curricula and programs. Acad Med. 2001;76:125-133. (Pubitemid 32151874)
43. Hewson MG, Copeland HL, Mascha E, et al. Integrative medicine: implementation and evaluation of a professional development program using experiential learning and conceptual change teaching approaches. Patient Educ Couns. 2006;62:5-12. (Pubitemid 43832073)
44. Gopee N. The role of peer assessment and peer review in nursing. Br J Nurs. 2001;10:115-121.