Special Feature

Report illustrates AMA's leadership on patient safety

More medical liability claims stem from events that occurred in ambulatory settings than anywhere else, and two-thirds of them involve major injury or death, according to a recent article in the Journal of the American Medical Association. Despite this, there is a serious shortage of reliable data needed to improve patient safety in outpatient care.

That's the focus of a recent AMA report that found major gaps in medicine's understanding of ambulatory safety. The report, which examined medication safety, diagnostic errors, office-based surgery and anesthesia, the patient role in care, and communication safety from 2000 to 2010, highlights the need for credible studies that can show how to improve safety in ambulatory settings.

Most research on patient safety has examined hospital care, but the majority of care occurs in outpatient settings. According to the report, only one patient is admitted to a hospital for every 300 patients seen in an ambulatory setting.

Gordon Schiff, MD, an internist in Boston who reviewed parts of the report for the AMA, said the frantic pace of outpatient care oftentimes makes it difficult for physicians to step back and see where they can improve safety. He said the report is a message to physicians that they are not alone in wanting to ensure safety in ambulatory settings.

"This report comes at an important time," said Dr. Schiff, associate director of the Center for Patient Safety Research and Practice at Brigham and Women's Hospital. "It's not about whether or not we need to do better in outpatient care, but how to best do that, especially given all the competing priorities for outpatient physicians."

The report is a prime example of the national leadership the AMA provides in all facets of patient safety. Another is a new medication disposal guide, unveiled Monday, that physicians can give their patients reminding them to dispose of expired, unwanted and unused medicines properly.

The AMA timed its release of the guide to coincide with National Patient Safety Awareness Week, which is observed this week through Saturday. It adds to a long list of AMA resources emphasizing that patient safety is a unified partnership between physicians and their patients.

Among these resources is the My Medications app, through which patients can store information on prescriptions, immunization records and allergies, and email that information to physicians and family members. In addition, a "medication safety checklist" helps facilitate patients' conversations with physicians about the medications they are taking and the questions they should be asking.

The AMA also offers physicians a toolkit informing them about the growing concern of health literacy in the United States. And a series of webinars covers various patient safety topics, including communicating events and errors to patients, and relating safety lessons learned by NASA to medicine.

Learn more about what the AMA is doing to ensure patient safety in all settings of care.