BMJ 2001;322:1425 ( 9 June )

Letters

Adverse events in British hospitals

    Preventive strategies, not epidemiological studies, are needed
    "Errors meetings" in radiology did not identify errors leading to complaints and litigation
    Hospital acquired infections consume bed days and resources
    Threshold used for determining adverse events is important
    Adverse events may occur whatever course of action is pursued
    Authors' reply
    Retrospective case record analysis has been superseded
    Expanded definition of adverse events is needed

Preventive strategies, not epidemiological studies, are needed

The first 150 words of the full text of this article appear below.

EDITOR---Vincent et al estimated that about 11% of hospital admissions in two hospitals were associated with an adverse event and argue for a larger study to document the prevalence of such adverse events in the United Kingdom.1 Their estimate of adverse events occurring in hospital is well within the statistical boundary of previous estimates obtained by much larger studies in the United States2 and Australia3; their argument for yet another large study therefore seems weak. Sufficient evidence already exists; there is an urgent need now for strategies to prevent or reduce the error, not for another descriptive epidemiological study.

Death, cardiac arrest, and unplanned admissions to an intensive care unit are probably the most serious among the adverse events. Most of these events have their genesis in general wards; they are not sudden or unpredictable, because they are usually preceded by signs of clinical instability. Because of . . . [Full text of this article]
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