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Is the "July Effect" Real? Pediatric Trainee Reported Medical Errors and Adverse Events.

Ankoor Y Shah1, Andrew Abreo1, Nicole Akar-Ghibril1

  • 1Department of General and Community Pediatrics, Children's National Health System, Washington, D.C.; Division of Allergy, Pulmonary, and Critical Care, Vanderbilt University Medical Center, Nashville, Tenn.; Department of Pediatrics, University of Miami, Miami, Fla.; §Division of Risk Management, Children's National Health System, Washington, D.C.; and ||Division of Quality and Safety, Children's National Health System, Washington, D.C.

Pediatric Quality & Safety
|September 20, 2018
PubMed
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The "July Effect" may increase pediatric resident medical errors in July, but does not increase adverse events. This study analyzed medical errors and adverse events in pediatric trainees during July 2015.

Area of Science:

  • Medical Education Research
  • Patient Safety
  • Pediatric Healthcare Quality

Background:

  • The "July Effect" hypothesis posits increased patient adverse events due to new medical providers starting in July.
  • This phenomenon is attributed to the influx of new trainees at the beginning of the academic year.
  • Understanding this effect is crucial for maintaining patient safety and quality of care in teaching hospitals.

Purpose of the Study:

  • To investigate whether reported pediatric trainee medical errors and subsequent adverse events increase in July.
  • To analyze medical error data from May through September 2015 at a tertiary care children's hospital.
  • To determine if the "July Effect" is observable in pediatric residency programs.

Main Methods:

  • Utilized an established error surveillance system to collect data on near misses, adverse events, and medical errors.

Related Experiment Videos

  • Reviewed electronic reports submitted between May and September 2015.
  • Calculated and compared the incidence of medical errors per 1,000 trainee-days, focusing on July compared to adjacent months.

    • Main Results:

    • Pediatric residents reported significantly more medical errors in July (31) compared to May (16), June (16), and August (19).
    • No significant difference was found in the number of adverse events resulting from trainee medical errors in July (7) compared to May (5), June (8), August (4), or September (8).
    • A total of 282 trainees were active during the study period.

    Conclusions:

    • This single-center study indicates an increase in reported medical errors by pediatric residents during July.
    • However, the study found no corresponding increase in adverse events stemming from these errors in July.
    • Findings suggest that while error reporting may rise, patient harm does not necessarily increase due to the "July Effect" in this pediatric setting.