Online Program

Developing and pilot testing a psychiatry-specific adverse event medical record screening tool

Monday, November 4, 2013

Sara Cullen, Ph.D., M.S.W., School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA
Steven Marcus, Ph.D., School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA
Richard Hermann, M.D., M.S., School of Medicine, Tufts Medical Center, Boston, MA
Background: Despite significant advances in assessing patient safety in general medicine and surgery, the incidence and nature of errors and adverse events in inpatient psychiatry remains largely unknown as research has mostly excluded individuals being treated for psychiatric disorders.

Methods: The current study develops a conceptual model of patient safety events in inpatient psychiatry, describes a newly developed tool, the Psychiatric Review Form, to examine patient safety events in inpatient psychiatry, and presents data from a preliminary medical record review study using the Psychiatric Review Form to review more than 1,500 charts (12 months of inpatient psychiatric discharge data) in three urban hospitals.

Results: The conceptual model proved instrumental in developing the Psychiatric Review Form to examine patient safety events in inpatient psychiatry. Using this form, three medical record abstractors found that between 11.1-26.6% of charts screened positive for a potential patient safety event in the three hospitals. Common patient safety incidents included adverse drug reactions, patient violence, falls, and drug administration events.

Discussion: This study provides the first systematic epidemiological examination of patient safety in hospital-based psychiatry, which served as the foundation for planning a larger study among a random sample of hospitals statewide. Epidemiological research on patient safety in psychiatry has significant policy implications and can inform targeted strategies to prevent medical errors and reduce adverse events, enhancing the provision of safe clinical care for this vulnerable patient population.

Learning Areas:

Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Discuss the development of a screening tool to examine patient safety events in inpatient psychiatry. We will describe our experience utilizing this tool to study patient safety events in the inpatient psychiatric unit at three urban hospitals. Finally, we will explain how this data will be used to take the next steps in studying medical errors and adverse events among patients with psychiatric disorders.

Keyword(s): Psychiatric Epidemiology, Mental Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with the principal investigator for the last 8 years on this and other federally funded grants focused on developing epidemiological evidence on patient safety in inpatient psychiatry. I have been the principal investigator on a federally funded (dissertation) grant on the intersection of mental illness and health care utilization. My scientific interests include improving the quality of care for individuals and families impacted by psychiatric disorders.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.