title: Critical incidents in a tertiary care clinic for internal medicine.
abstract: BACKGROUND
  Reducing medical errors has become an international concern. Population-based studies consistently demonstrate inacceptable high rates of medical injury and preventable deaths. Thus, electronic critical incident reporting systems are now increasingly used in hospitals, predominantly in anesthesia. However, studies systematically analyzing critical incidents are scarce. Our aim was to describe content and causes of critical incidents in our Clinic for Internal Medicine.
  
  
  RESULTS
  We retrospectively analyzed all critical incidents reported during a 54-months period. Between implementation and analysis, 456 incidents were reported anonymously in the commercially available platform-independent, web-based critical incident reporting system. All incidents were analyzed according to the reporting profession, time point during hospitalization process, content and potential causes.Most incidents occurred on medical wards (80%). The most frequent type of incidents was medication errors (62%). These incidents primarily occurred when prescribing and/or administering drugs (30% and 29% of medication errors respectively). So-called, human errors', i.e. occurring without apparent external factor, were the most frequently indicated cause of critical incidents (56%) followed by insufficient communication (26%). These problems primarily occurred between different groups of health care professionals and between different departments. The described types and reasons of critical incidents remained stable during the observation period.
  
  
  CONCLUSIONS
  The findings of our analysis of the character and type of critical incidents occurring in a tertiary care clinic for internal medicine reported in an anonymous, voluntary, electronic reporting system suggest that strategies to improve communication and medication delivery are most promising to avoid critical incidents.
authors.affiliation: Clinic for Internal Medicine, University Hospital Basel, Petersgraben 4, CH, 4031 Basel, Switzerland.
authors.forename: Paula
authors.initials: P
authors.lastname: Scharein
authors.forename: Marten
authors.initials: M
authors.lastname: Trendelenburg
mesh_terms: D000554:Ambulatory Care Facilities; D006801:Humans; D007388:Internal Medicine; D019300:Medical Errors