Root Cause Analysis and Medical Error Prevention

Excerpt

Medical error is an unfortunate reality of the healthcare industry and a topic that is continuously discussed due to its grave impact on patient care and outcomes. In a 1999 publication by the Institute of Medicine (IOM), it was highlighted that deaths resulting from medical error exceeded those attributed to motor vehicle accidents, breast cancer, or AIDS.

Subsequent reports that discuss potential etiologies of medical errors have blamed systemic issues. Others have focused attention on certain groups of patients that may be more vulnerable to medical error than others. Recently, the impact of medical errors on patient family members and healthcare professionals has been emphasized due to its effects on exacerbating burnout, poor work performance, mental health decline, and even suicidality.

Though it may be challenging to pinpoint the definitive cause of medical error in certain situations, it is important to evaluate strategies that can be used to mitigate and prevent these adverse events from occurring in the first place. One such method is root cause analysis, which has been previously shown to reduce clinical and surgical errors in various specialties by establishing a quality improvement framework. This article will discuss the application of root cause analysis in medical error prevention and strategies for maintaining continuous quality improvement in the healthcare setting.