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Table 11.2 Methods of measuring errors and adverse events.
Source: Adapted from Thomas and Petersen19.
| Study method | Advantages | Disadvantages |
|---|---|---|
| Administrative data analysis | Uses readily available data | May rely on incomplete and inaccurate data |
| Inexpensive | The data are divorced from clinical context | |
| Record review/chart review | Uses readily available data | Judgements about adverse events not reliable |
| Commonly used | Medical records are incomplete Hindsight bias | |
| Review of electronic medical records | Inexpensive after initial investment Monitors in real time Integrates multiple data sources | Susceptible to programming and/or data‐entry errors Expensive to implement |
| Observation of patient care | Potentially accurate and precise Provides data otherwise unavailable Detects more active errors than other methods | Time‐consuming and expensive Difficult to train reliable observers Potential concerns about confidentiality Possible to be overwhelmed with information |
| Active clinical surveillance | Potentially accurate and precise for adverse events | Time‐consuming and expensive |
Table 11.3 Methods of understanding errors and adverse events.
Source: Adapted from Thomas and Petersen19.
| Study method | Advantages | Disadvantages |
|---|---|---|
| Morbidity and mortality conferences and autopsy | Can suggest contributory factors Familiar to healthcare providers | Hindsight bias Reporting bias Focused on diagnostic errors Infrequently used |
| Case analysis/root cause analysis |
Can suggest contributory structured systems approach Includes recent data from interviews
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