While preventable harm in hospital settings has been a widely discussed issue for decades, new research suggests that adverse events are relatively common in outpatient settings, marking a critical opportunity to improve safety.
A team led by researchers at Boston-based Mass General Brigham conducted the study published May 7 in Annals of Internal Medicine. Researchers analyzed data on 3,103 patients who received care at 11 outpatient sites in Massachusetts in 2018.
Four key findings:
- Seven percent of patients had at least one adverse event, and 1.9% experienced at least one preventable event.
- Adverse drug events were the most common type (63.8%), followed by healthcare-associated infections (14.8%) and surgical or procedural events (14.2%).
- About 17% of adverse events were serious, and 2.1% were life-threatening.
- Adults 85 and older were disproportionately affected by adverse events in outpatient settings. Nearly 9% experienced preventable adverse events and 4.4% had serious adverse events.
Researchers said the findings merit urgent actions to prevent outpatient harm. For health systems, the first step is ensuring they're measuring patient safety in both inpatient and outpatient settings.
"Our study is an alarm bell. About 1-in-4 people every month are touched by outpatient care, yet we do not know enough about its safety. If we do not measure outpatient safety, we cannot start to improve care for all patients," corresponding author David Levine, MD, a clinician-investigator and internal medicine physician at Boston-based Brigham and Women's Hospital, said in a news release.