title: Attention to cancer patients' safety after primary treatment is needed.
abstract: BACKGROUND
  Knowledge about patient safety issues after primary treatment of cancer is sparse.
  
  
  METHODS
  The present article is a retrospective analysis of adverse events (AEs) after primary cancer treatment to characterise the types of AEs and their consequences. A total of 724 AEs reported from 2010 to 2013 were identified via the Danish Patient Safety Database. The International Classification for Patient Safety was used to characterise event types. Consequences were characterised as either psychical harm or delay. We focused on AEs in care transitions.
  
  
  RESULTS
  Common event types were administrative processes (58%), communication and documentation (56%), clinical processes (42%) and medication (27%). 46% of AEs led to physical harm. 4% resulted in severe physical harm or death. 18% resulted in delay in diagnosis of relapse or new cancer, treatment or referral. 50% of all AEs were related to care transitions. The AEs in care transitions carry great potential for prevention as they often relate to inadequate administrative practices, poor communication and documentation, or to unclear transferal of responsibility for the patient.
  
  
  CONCLUSIONS
  Attention to patient safety after primary cancer treatment is required. The identification of a substantial number of AEs in care transitions stresses a need for increased continuity and clear transfer of responsibility in cancer care after primary treatment. To support learning from AEs, the AE reports should provide more details on the contextual factors.
authors.affiliation: The Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, 2100 Copenhagen, Denmark. annhch@cancer.dk.
authors.forename: Anne Hjøllund
authors.initials: AH
authors.lastname: Christiansen
authors.forename: Henriette
authors.initials: H
authors.lastname: Lipczak
authors.forename: Janne Lehmann
authors.initials: JL
authors.lastname: Knudsen
mesh_terms: D003142:Communication; D016208:Databases, Factual; D003718:Denmark; D004282:Documentation / Q000592:standards; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D009369:Neoplasms / Q000628:therapy*; D061214:Patient Safety / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D000069341:Transitional Care / Q000592:standards / Q000706:statistics & numerical data*