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  • 1Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York; the Department of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, New York; the Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York; and the Department of Obstetrics & Gynecology, Columbia University Irving Medical Center, New York, New York.

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Summary
This summary is machine-generated.

Wrong-patient orders occurred nearly twice as often in obstetric units compared to medical-surgical units. Implementing safety strategies from other specialties may improve maternity care safety.

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Area of Science:

  • Healthcare Quality and Safety
  • Patient Safety Research
  • Medical Error Analysis

Background:

  • Wrong-patient orders are a significant patient safety concern.
  • Understanding variations in error rates across different clinical settings is crucial for targeted interventions.
  • Obstetric units have unique workflows that may influence order accuracy.

Purpose of the Study:

  • To compare the incidence of wrong-patient orders between obstetric units and medical-surgical units.
  • To identify specific patient populations and clinical contexts associated with higher error rates.
  • To inform the development of strategies to enhance patient safety in maternity care.

Main Methods:

  • Observational study utilizing electronic health record data from a large health system (2016-2018).
  • Employed the Wrong-Patient Retract-and-Reorder (WPRR) measure to identify near-miss wrong-patient orders.
  • Used multilevel logistic regression to compare error rates between unit types, adjusting for clinician and timing factors.

Main Results:

  • Obstetric units had a significantly higher rate of wrong-patient orders (79.5 per 100,000 order sessions) compared to medical-surgical units (42.3 per 100,000).
  • The odds ratio for wrong-patient orders in obstetrics was 1.98 (95% CI 1.64-2.39).
  • Higher error rates in obstetrics were observed for attending physicians and house staff, with no significant difference between day and night shifts.

Conclusions:

  • Order errors are more frequent in obstetric units than in medical-surgical units.
  • Evidence-based safety strategies proven effective in other high-risk specialties should be evaluated for implementation in obstetrics.
  • Enhancing maternity care safety requires addressing the specific risks identified in obstetric settings.