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New Docs Linked to Death
Spike in July
Newswise — Are new medical residents a
threat to patient health? According to
sociology professor David Phillips and his
student Gwendolyn Barker from the University
of California, San Diego, fatal medication
errors peak in July in counties with
teaching hospitals, which coincides with the
yearly influx of new medical residents who
are given increased responsibility for
patient care.
Their findings are published in the Journal
of General Internal Medicine, the
official journal of the Society of General
Internal Medicine, published by Springer.
Phillips and Barker looked at the
relationship between inexperience and
medical error by focusing on changes in the
number of medication mistakes (involving
accidental overdose of a drug, wrong drug
given or taken in error, drug taken
inadvertently, and accidents in the use of
drugs in medical and surgical procedures) in
July, when thousands begin medical
residencies.
They tested the hypothesis that the arrival
of new medical residents in July is
associated with increased fatal medication
errors.
They examined 244,388 U.S. death
certificates issued between 1979 and 2006,
focusing on fatal medication errors as the
recorded primary cause of death. They
compared the observed number of deaths in
July with the number of expected events in a
given month for a given year.
They also looked at whether there were any
differences between deaths in and out of
hospitals in July as well as between
counties with and without teaching
hospitals.
The authors found that inside medical
institutions, fatal medication errors spiked
in July and in no other month.
This July peak was visible only in counties
with teaching hospitals. In these counties,
the number of July deaths from medication
errors was 10 percent above the expected
level. No similar link was observed for
other causes of death or for deaths outside
hospitals.
The authors highlight several implications
for medical policy. “Our findings,” they
write, “provide fresh evidence for 1)
re-evaluating responsibilities assigned to
new residents; 2) increasing supervision of
new residents; 3) increasing education
concerned with medication safety.
Incorporating these changes might reduce
both fatal and non-fatal medication errors
and thereby reduce the substantial costs
associated with these errors.”
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