4.2 Article

Reducing Medical Errors in Primary Care Using a Pragmatic Complex Intervention

Journal

ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH
Volume 27, Issue 6, Pages 670-677

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/1010539514564007

Keywords

Diagnostic errors; medical errors; medication errors; nurse practitioners; primary health care

Funding

  1. National Institutes of Health Malaysia Research Grant
  2. 9th Malaysia Plan Research Priority Area Health Policy and Systems [(02) dlm. KKM/MIHSEC/08/0805, NMRR-07-768-1040, NMRR-07-770-1042]
  3. regional state health departments

Ask authors/readers for more resources

This study aimed to develop an intervention to reduce medical errors and to determine if the intervention can reduce medical errors in public funded primary care clinics. A controlled interventional trial was conducted in 12 conveniently selected primary care clinics. Random samples of outpatient medical records were selected and reviewed by family physicians for documentation, diagnostic, and management errors at baseline and 3 months post intervention. The intervention package comprised educational training, structured process change, review methods, and patient education. A significant reduction was found in overall documentation error rates between intervention (Pre 98.3% [CI 97.1-99.6]; Post 76.1% [CI 68.1-84.1]) and control groups (Pre 97.4% [CI 95.1-99.8]; Post 89.5% [85.3-93.6]). Within the intervention group, overall management errors reduced from 54.0% (CI 49.9-58.0) to 36.6% (CI 30.2-43.1) and medication error from 43.2% (CI 39.2-47.1) to 25.2% (CI 19.9-30.5). This low-cost intervention was useful to reduce medical errors in resource-constrained settings.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.2
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Oncology

Effectiveness of Decision Aid in Men with Localized Prostate Cancer: a Multicenter Randomized Controlled Trial at Tertiary Referral Hospitals in an Asia Pacific Country

N. B. Jalil, P. Y. Lee, M. Z. Nor Afiah, K. L. Abdullah, F. N. S. Mohd Azizi, N. N. S. Abdul Rassip, T. A. Ong, C. J. Ng, Y. K. Lee, A. T. Cheong, A. H. Razack, M. Saad, A. Alip, R. Malek, M. Sundram, S. Omar, J. R. Sathiyananthan, P. Kumar

Summary: This study aimed to evaluate the effectiveness of a PDA modified to the local context in improving patients' knowledge, decisional conflict, and preparation for decision making among men with localized prostate cancer. Although the intervention group showed significant improvement in knowledge and decisional conflict, there were no significant differences between the control and intervention groups in terms of knowledge, decisional conflict, and preparation for decision-making.

JOURNAL OF CANCER EDUCATION (2022)

Correction Multidisciplinary Sciences

Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review (vol 14, e0216402, 2019)

Adina Abdullah, Su May Liew, Hani Salim, Chirk Jenn Ng, Karuthan Chinna

PLOS ONE (2022)

Article Public, Environmental & Occupational Health

Psychological well-being, quality of life and patient satisfaction among adults with chronic spontaneous urticaria in a multi-ethnic Asian population

Shin Shen Yong, Suganthy Robinson, Zhenli Kwan, Ee Ming Khoo, Winn Hui Han, Leng Leng Tan, Su-Ming Wong, Min Moon Tang

Summary: Patients with chronic spontaneous urticaria have an increased risk of psychological distress. Low income and severe disease are significant predictors of depression, while severe disease also affects quality of life and depression levels.

PSYCHOLOGY HEALTH & MEDICINE (2023)

Review Respiratory System

Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis

Md. Nazim Uzzaman, Dhiraj Agarwal, Soo Chin Chan, Julia Patrick Engkasan, G. M. Monsur Habib, Nik Sherina Hanafi, Tracy Jackson, Paul Jebaraj, Ee Ming Khoo, Fatim Tahirah Mirza, Hilary Pinnock, Ranita Hisham Shunmugam, Roberto A. Rabinovich

Summary: Home-based pulmonary rehabilitation is equally effective as centre-based rehabilitation in improving functional exercise capacity and quality of life for patients with chronic respiratory diseases compared to usual care.

EUROPEAN RESPIRATORY REVIEW (2022)

Article Multidisciplinary Sciences

Prevalence and associated factors of delayed sputum smear conversion in patients treated for smear positive pulmonary tuberculosis: A retrospective follow up study in Sabah, Malaysia

Linghui Amanda Khor, Ulfa Nur Izzati A. Wahid, Lee Lee Ling, Sarah Michael S. Liansim, Jush'n Oon, Mahendran Naidu Balakrishnan, Wei Leik Ng, Ai Theng Cheong

Summary: This retrospective study conducted in three government health clinics in Sabah, Malaysia on newly diagnosed smear positive pulmonary tuberculosis patients from 2017 to 2019 showed that 8.8% of patients did not convert to smear negative at the end of the intensive treatment phase. Older patients (age >= 60), foreigners, and patients with higher sputum bacillary load at diagnosis were more likely to have delayed sputum smear conversion. Healthcare providers should be aware of these factors and ensure proper follow-up treatment for patients.

PLOS ONE (2023)

Article Primary Health Care

Healthcare resources, organisational support and practice in asthma in six public health clinics in Malaysia

Norita Hussein, Rizawati Ramli, Su May Liew, Nik Sherina Hanafi, Ping Yein Lee, Ai Theng Cheong, Shariff-Ghazali Sazlina, Azainorsuzila Mohd Ahad, Jaiyogesh Patel, Jurgen Schwarze, Hilary Pinnock, Ee Ming Khoo

Summary: This study investigated the management of asthma in Malaysian primary care settings. It found insufficient resources and organizational support, as well as areas for improvement in doctors' practices.

NPJ PRIMARY CARE RESPIRATORY MEDICINE (2023)

Article Multidisciplinary Sciences

Effect of supplementary private health insurance on inpatient utilisation: Evidence from Malaysia

Nur Zahirah Balqis-Ali, Anis-Syakira Jailani, Weng Hong Fun, Suhana Jawahir, Sondi Sararaks, Grace H. Y. Lee

Summary: Supplementary private health insurance provides better healthcare access, improves health outcomes, and potentially reduces health system costs. Improperly regulated private health insurance may worsen inequity of access and encourage moral hazard, altering health-seeking behavior. This study investigates the impact of private health insurance ownership on private inpatient care utilization, frequency of admission, and length of stay using Malaysian National Health Morbidity Survey data.

HELIYON (2023)

Review Medicine, Research & Experimental

Implementing an Evidence-Based COPD Hospital Discharge Protocol: A Narrative Review and Expert Recommendations

Marc Miravitlles, Mohit Bhutani, John R. Hurst, Frits M. E. Franssen, Job F. M. van Boven, Ee Ming Khoo, Jing Zhang, Stephen Brunton, Daiana Stolz, Tonya Winders, Kazuhisa Asai, Jane E. Scullion

Summary: Discharge bundles aim to optimize patient outcomes for those hospitalized with exacerbation of COPD. Although previous studies suggest their effectiveness, inconsistencies in content and implementation have been observed. To ensure high-quality care and reduce readmission rates, a comprehensive discharge protocol is proposed, along with strategies to address implementation barriers. By utilizing successful implementation strategies from other disease areas, discharge bundles can be delivered more effectively to improve patient outcomes and ensure continuity of care.

ADVANCES IN THERAPY (2023)

Article Infectious Diseases

Factors associated with all-cause mortality in tuberculosis patients in a Malaysian tertiary hospital

Chee Kuan Wong, Kee Seong Ng, Sarah Qian Rou Choo, Choon Jiat Lee, Yik Pheng Teo, Su May Liew, Karuthan Chinna, Ee Ming Khoo, Wei Leik Ng, Peter Seah Keng Tok, Yan Shen Kee, De Min Chiang

Summary: On average, one in seven patients diagnosed with TB died within a year in a Malaysian tertiary hospital equipped with an electronic medical record system. Identification of this vulnerable group using the associated factors found in this study may help to reduce the risk of mortality through early intervention strategies.

JOURNAL OF INFECTION IN DEVELOPING COUNTRIES (2023)

Meeting Abstract Respiratory System

Burden of chronic respiratory diseases in population in four South/South-East Asian low-and middle-income countries (LMICs)

D. Agarwal, N. S. Hanafi, E. M. Khoo, R. A. Parker, D. Ghorpade, S. Salvi, A. I. A. Bakar, K. Chinna, D. Das, M. Habib, N. Hussein, R. Isaac, M. S. Islam, M. S. Khan, S. M. Liew, Y. K. Pang, B. Paul, S. K. Saha, L. P. Wong, O. M. Yusuf, S. O. Yusuf, S. Juvekar, H. Pinnock, B. Paul

EUROPEAN RESPIRATORY JOURNAL (2022)

Meeting Abstract Respiratory System

A feasibility study of a school-based asthma programme in Malaysia conducted during COVID-19 pandemic

S. N. Ramdzan, E. M. Khoo, S. M. Liew, S. Cunningham, H. Pinnock, E. M. Khoo

EUROPEAN RESPIRATORY JOURNAL (2022)

Article Tropical Medicine

Health system preparedness in infectious diseases: perspective of Malaysia, a middle-income country, in the face of monkeypox outbreaks

Chang Chee Tao, Xin-Jie Lim, Awatef Amer Nordin, Chern Choong Thum, Sondi Sararaks, Kalaiarasu Periasamy, Philip Rajan

Summary: The World Health Organization has declared monkeypox as a Public Health Emergency of International Concern. Malaysia has developed a five-point strategy to prepare for the disease, and various strategies for developing resilience in the face of global infectious disease spread were discussed. Malaysia's disease preparedness and response framework has established a proactive and responsive health system.

TROPICAL MEDICINE AND HEALTH (2022)

Article Primary Health Care

Psychological health and wellbeing of primary healthcare workers during COVID-19 pandemic in Malaysia: a longitudinal qualitative study

Ee Ming Khoo, Adina Abdullah, Su May Liew, Norita Hussein, Nik Sherina Hanafi, Ping Yein Lee, Khatijah Lim Abdullah, Lelamekala Vengidasan, Ahmad Ihsan Bin Abu Bakar, Hilary Pinnock, Tracy Jackson

Summary: This study examined the impact of the COVID-19 pandemic on the psychological health and wellbeing of primary healthcare workers in Malaysia. Findings showed that frontline healthcare workers initially experienced fear and stigma, but as time passed, they felt safer and focused on keeping others safe. Support from family, colleagues, and employers, as well as personal coping strategies, were important for maintaining their psychological health and wellbeing.

BMC PRIMARY CARE (2022)

Article Health Care Sciences & Services

Applying Discrete Event Simulation to Reduce Patient Wait Times and Crowding: The Case of a Specialist Outpatient Clinic with Dual Practice System

Weng Hong Fun, Ee Hong Tan, Ruzelan Khalid, Sondi Sararaks, Kar Foong Tang, Iqbal Ab Rahim, Shakirah Md. Sharif, Suhana Jawahir, Raoul Muhammad Yusof Sibert, Mohd Kamal Mohd Nawawi

Summary: This study aims to evaluate the effects of changing consultation start time and patient arrival on wait times and crowding in an outpatient clinic with a dual practice system. The analysis based on a discrete event simulation model shows that early consultation start time that matches patient arrival time and staggered arrival could significantly reduce the overall clinic turnaround time and the number of patients waiting during peak hours. This finding is important for narrowing the wait time gap between public and private patients.

HEALTHCARE (2022)

No Data Available