Health care experts at the University of California, San Francisco highlight in a new report the hidden risks and complexities that compromise patient safety for ambulatory patients with chronic disease.
While most prior research in patient safety has focused on preventing medical errors during hospital stays, the UCSF team emphasizes that more attention should be paid to chronic disease patients who receive care on an outpatient basis.
The team’s analysis appears in the July 2009 edition of the Joint Commission Journal on Quality and Patient Safety in an article titled “Refocusing the Lens: Patient Safety in Ambulatory Chronic Disease Care.” The article describes how gaps in the current health care system undermine safety in the outpatient setting, leading to preventable death and disability as well as unnecessary costs.
Unlike acute care settings, where patients receive care from trained teams of clinicians guided by protocols, the outpatient setting involves patients performing the day-to-day self-management of their chronic conditions, often in the absence of clear protocols, said lead author Urmimala Sarkar, MD, MPH, assistant professor of medicine in the UCSF Division of General Internal Medicine and the Center for Vulnerable Populations at San Francisco General Hospital Medical Center.
The authors assert that ambulatory settings present unique challenges, such as lack of communication between health systems, communities with inadequate resources, and patients struggling to manage multiple medications and complicated treatment regimens. They aim to refocus attention on the issue of ambulatory patient safety, because they have seen the adverse effects of medical errors in their own outpatient practices.