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Related Experiment Videos

Medication errors: not just a few "bad apples"

Daren Nicholson1, William Hersh, Tejal K Gandhi

  • 1Oregon Health & Science University, Portland OR.

Journal of Clinical Outcomes Management : JCOM
|July 25, 2006
PubMed
Summary

Most physicians make medication errors, challenging the "few bad apples" theory. This study found medication errors were widely distributed among internal medicine physicians, not concentrated in a small group.

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Area of Science:

  • Medical Practice
  • Patient Safety
  • Internal Medicine

Background:

  • Medication errors are a significant concern in healthcare.
  • Understanding the distribution of these errors is crucial for targeted interventions.

Purpose of the Study:

  • To describe the distribution of medication errors among physicians.
  • To investigate whether errors are concentrated in a few individuals or widely spread.

Main Methods:

  • Prospective data collection over seven months from 24 internal medicine physicians in four primary care practices.
  • Patient surveys and chart reviews were used to identify adverse drug events (ADEs).
  • Medication errors per physician and prescriptions written were the primary measurements.

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Main Results:

  • Twenty-two out of 24 physicians made at least one medication error.
  • The error rate was evenly distributed among the physicians, with one outlier.
  • This wide distribution challenges the 'few bad apples' hypothesis.

Conclusions:

  • Medication errors are not solely attributable to a small subset of physicians.
  • Interventions to reduce medication errors should consider a broader approach beyond targeting individual outliers.
  • Findings suggest systemic factors may contribute to widespread medication errors.