Addressing Postdischarge Adverse Events: A Neglected Area
Addressing Postdischarge Adverse Events: A Neglected Area
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DOI：
10.1016/s1553-7250(08)34011-2
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发表时间：
2008-02-01
影响因子：
2.3
通讯作者：
Bates, David Westfall
中科院分区：
文献类型：
--
作者：
Tsilimingras, Dennis;Bates, David Westfall
背景：出院后安全是一个长期被忽视的领域。美国和加拿大最近的研究发现，大约五分之一的患者出院回家从一般内科服务的主要教学医院遭受的adverse events.Methods：MEDLINE，科克伦数据库，并参考清单检索的文章被用于文献检索的文章从1966年至2007年5月发表。患者安全性研究主要集中在住院患者的不良事件上。虽然有一些关于门诊环境的数据，但关注出院后不良事件的研究更少。只有两项在北美进行的研究检查了所有类型的出院后不良事件的发生率。在现有证据的基础上，改善出院后护理的关键领域如下：（1）改善过渡期护理，（2）通过战略性使用电子健康记录改善信息传递，（3）药物协调，（4）改善检查结果的随访，（5）使用筛查方法识别发生不良事件的患者。有限的证据表明，大约五分之一的内科患者在从北美医院出院后发生不良事件。患者安全专家应将出院后不良事件的风险视为一个重要的关注领域。
Background: Postdischarge safety is an area that has long been neglected. Recent studies from the United States and Canada found that about one in five patients discharged home from the general internal medicine services of major teaching hospitals suffered an adverse event.Methods: MEDLINE, Cochrane databases, and reference lists of retrieved articles were used in a literature search of articles published from 1966 through May 2007.Findings: Patient safety research has focused mostly on adverse events in hospitalized patients. Although some data are available about the ambulatory setting, even fewer studies have been done focusing on adverse events following hospital discharge. Only two studies conducted in North America have examined the incidence rate of all types of postdischarge adverse events. On the basis of the available evidence, key areas of opportunity to improve postdischarge care are as follows: (1) improving transitional care, (2) improving information transfer through strategic use of electronic health records, (3) medication reconciliation, (4) improving follow-up of test results, and (5) using screening methods to identify patients with adverse events.Discussion: Limited evidence suggests that about one in five internal medicine patients suffers an adverse event after discharge from a North American hospital. The risk of postdischarge adverse events should be recognized by patient safety experts as an important area of concern.