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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 following surgery or treatment and is a result of human error in medical intervention. Human errors can be caused by systems failures such as poor management decisions, poor communications, insufficient resources, poor staffing, poor documentation, or a lack of safeguards and check points. Technical mistakes and the inability to deal with the
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complexities or demands of the healthcare system can also cause medical errors. It has been found that medical outsourcing of noncore tasks can help to a great extent. The Adverse Events Statistics The study covered three hospitals in the Midwest that are part of an integrated healthcare system. Data was examined from 2006 till 2009 for the reported AE rates covering 96 categories which were classified according to type, patient age and severity. The researchers discovered that of the 82,784 hospitalizations, at least a single surgical procedure and one AE was reported in 6.5% of the hospitalizations, which amounted to 5,368 cases. The mean AE rate among the surgical procedure groups was 82.8 per 1000 hospitalizations. In surgical categories, though, the AE rate was as high as 555.7 per 1000 for operations performed on the pericardium and heart. AEs most commonly included care management. Medication events were next, followed by invasive procedures. Electronic reporting systems have been developed by healthcare facilities to identify
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and promptly report AEs which eventually leads to measures for improving patient safety. This study has been comprehensive in analyzing systematically the AE rate variations in various kinds of surgery. It has also specifically identified particular AE types which are the most common in each of the surgical categories. The study also helps identify AE category severity levels. Fatigue – the Primary Culprit It has been reported that fatigue is the reason for over 1600 events that have been reported to the PPSA (Pennsylvania Patient Safety Authority). Thirty seven of these cases were adverse events, and four of these adverse events also led to the death of the patients. Most of the fatigue related events were caused by errors in medication or mistakes in connection with any procedure. The study also discovered that nurses working for more than 12.5 hours have a greater chance of incurring fatigue because of which mistakes could occur. But PPSA also claims that efforts are also being made to reduce the working hours of nurses and other medical staff, though deeper and more extensive measures needed to be carried
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out as fatigue cannot be addressed by reducing the working hours alone. How Fatigued Staff Pose Major Risk Fatigued medical staff, as in other industries, could display features such as attention lapses, problems with focus, reduced motivation, confusion, inefficient problem solving, memory lapses, irritability, loss of empathy, flawed communication, etc. Studies with nurses revealed that working overtime or in 12-hour work shifts could result in difficulties in remaining awake and alert during duty hours. The risk of errors is therefore three times greater. Working 12.5 hours or more posed the highest risk. Grim Reminder of What Fatigue Could Do A classic case of fatigue was reported of a Wisconsin-registered nurse in 2006. She was charged with class H felony for mistakenly administering an epidural medication to a patient in place of the antibiotic prescribed. On investigating the Wisconsin Department of Regulation and Licensing records, it emerged that the nurse was on two consecutive eighthour shifts which ended on the midnight of the
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day of the incident following which she was scheduled to join for the next eight-hour shift in the morning at 7 AM. How Medical Outsourcing Can Help Fatigue seems to be the major contributory factor of adverse events following surgery or treatment. Much of this can be avoided through medical outsourcing of non-core tasks such as medical coding, billing, A/R collections, forms processing, transcription, and so on. With a professional team handling these tasks, healthcare providers can focus better on what they do and avoid causing unintentional harm to patients.