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Sins of Omission

dc.contributor.authorHayward, Rodney A.en_US
dc.contributor.authorAsch, Steven M.en_US
dc.contributor.authorHogan, Mary M.en_US
dc.contributor.authorHofer, Timothy P.en_US
dc.contributor.authorKerr, Eve A.en_US
dc.date.accessioned2010-06-01T21:30:40Z
dc.date.available2010-06-01T21:30:40Z
dc.date.issued2005-08en_US
dc.identifier.citationHayward, Rodney A.; Asch, Steven M.; Hogan, Mary M.; Hofer, Timothy P.; Kerr, Eve A. (2005). "Sins of Omission." Journal of General Internal Medicine 20(8): 686-691. <http://hdl.handle.net/2027.42/74567>en_US
dc.identifier.issn0884-8734en_US
dc.identifier.issn1525-1497en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/74567
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=16050875&dopt=citationen_US
dc.description.abstractLittle is known about the relative incidence of serious errors of omission versus errors of commission. Objective : To identify the most common substantive medical errors identified by medical record review. Design : Retrospective cohort study. Setting : Twelve Veterans Affairs health care systems in 2 regions. Participants : Stratified random sample of 621 patients receiving care over a 2-year period. Main Outcome Measure : Classification of reported quality problems. Methods : Trained physicians reviewed the full inpatient and outpatient record and described quality problems, which were then classified as errors of omission versus commission. Results : Eighty-two percent of patients had at least 1 error reported over a 13-month period. The average number of errors reported per case was 4.7 (95% confidence intervals [CI]: 4.4, 5.0). Overall, 95.7% (95% CI: 94.9%, 96.4%) of errors were identified as being problems with underuse. Inadequate care for people with chronic illnesses was particularly common. Among errors of omission, obtaining insufficient information from histories and physicals (25.3%), inadequacies in diagnostic testing (33.9%), and patients not receiving needed medications (20.7%) were all common. Out of the 2,917 errors identified, only 27 were rated as being highly serious, and 26 (96%) of these were errors of omission. Conclusions : While preventing iatrogenic injury resulting from medical errors is a critically important part of quality improvement, we found that the overwhelming majority of substantive medical errors identifiable from the medical record were related to people getting too little medical care, especially for those with chronic medical conditions.en_US
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dc.format.extent3109 bytes
dc.format.mimetypeapplication/pdf
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dc.publisherBlackwell Science Incen_US
dc.rights© 2005 by the Society of General Internal Medicine. All rights reserveden_US
dc.subject.otherQuality of Careen_US
dc.subject.otherAdverse Eventsen_US
dc.subject.otherPatient Safetyen_US
dc.subject.otherMedical Errorsen_US
dc.titleSins of Omissionen_US
dc.typeArticleen_US
dc.subject.hlbsecondlevelInternal Medicine and Specialtiesen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumDepartment of Internal Medicine, University of Michigan, Ann Arbor, Mich, USA ;en_US
dc.contributor.affiliationotherVeterans Affairs Health Services Research & Development Center of Excellence, Ann Arbor, Mich, USA ;en_US
dc.contributor.affiliationotherVeterans Affairs Greater Los Angeles Health Care System and the Division of General Internal Medicine, David Geffen School of Medicine at UCLA, Los Angeles CA, and the Rand Health Program, Santa Monica, Calif, USA.en_US
dc.identifier.pmid16050875en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/74567/1/j.1525-1497.2005.0152.x.pdf
dc.identifier.doi10.1111/j.1525-1497.2005.0152.xen_US
dc.identifier.sourceJournal of General Internal Medicineen_US
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