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Psychiatr Serv. Author manuscript; available in PMC 2016 October 04. Published in final edited form as: Psychiatr Serv. 2016 October 1; 67(10): 1068–1075. doi:10.1176/appi.ps.201500415.
Patient Safety Events and Harms During Medical and Surgical Hospitalizations for Persons With Serious Mental Illness Dr. Gail L. Daumit, M.D., M.H.S., Dr. Emma E. McGinty, Ph.D., M.S., Dr. Peter Pronovost, M.D., Ph.D., Dr. Lisa B. Dixon, M.D., M.P.H., Dr. Eliseo Guallar, M.D., P.H., Dr. Daniel E. Ford, M.D., M.P.H., Dr. Elizabeth K. Cahoon, Ph.D., S.M., Dr. Romsai T. Boonyasai, M.D., M.P.H., and Dr. David Thompson, D.N.Sc., M.S
Author Manuscript
Dr. Daumit, Dr. Ford, and Dr. Boonyasai are with the Department of Internal Medicine, and Dr. Pronovost and Dr. Thompson are with the Department of Anesthesiology and the Department of Critical Care Medicine, all at Johns Hopkins University School of Medicine, Baltimore. Dr. Daumit is also with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, where Dr. McGinty is affiliated. Dr. Dixon is with the New York State Psychiatric Institute and the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Guallar is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Cahoon is with the Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
Author Manuscript
Abstract Objective—This study explored the risk of patient safety events and associated nonfatal physical harms and mortality in a cohort of persons with serious mental illness. This group experiences high rates of medical comorbidity and premature mortality and may be at high risk of adverse patient safety events. Methods—Medical record review was conducted for medical-surgical hospitalizations occurring during 1994–2004 in a community-based cohort of Maryland adults with serious mental illness. Individuals were eligible if they died within 30 days of a medical-surgical hospitalization and if they also had at least one prior medical-surgical hospitalization within five years of death. All admissions took place at Maryland general hospitals. A case-crossover analysis examined the relationships among patient safety events, physical harms, and elevated likelihood of death within 30 days of hospitalization.
Author Manuscript
Results—A total of 790 hospitalizations among 253 adults were reviewed. The mean number of patient safety events per hospitalization was 5.8, and the rate of physical harms was 142 per 100 hospitalizations. The odds of physical harm were elevated in hospitalizations in which 22 of the 34 patient safety events occurred (p
Psychiatr Serv. Author manuscript; available in PMC 2016 October 04. Published in final edited form as: Psychiatr Serv. 2016 October 1; 67(10): 1068–1075. doi:10.1176/appi.ps.201500415.
Patient Safety Events and Harms During Medical and Surgical Hospitalizations for Persons With Serious Mental Illness Dr. Gail L. Daumit, M.D., M.H.S., Dr. Emma E. McGinty, Ph.D., M.S., Dr. Peter Pronovost, M.D., Ph.D., Dr. Lisa B. Dixon, M.D., M.P.H., Dr. Eliseo Guallar, M.D., P.H., Dr. Daniel E. Ford, M.D., M.P.H., Dr. Elizabeth K. Cahoon, Ph.D., S.M., Dr. Romsai T. Boonyasai, M.D., M.P.H., and Dr. David Thompson, D.N.Sc., M.S
Author Manuscript
Dr. Daumit, Dr. Ford, and Dr. Boonyasai are with the Department of Internal Medicine, and Dr. Pronovost and Dr. Thompson are with the Department of Anesthesiology and the Department of Critical Care Medicine, all at Johns Hopkins University School of Medicine, Baltimore. Dr. Daumit is also with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, where Dr. McGinty is affiliated. Dr. Dixon is with the New York State Psychiatric Institute and the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Guallar is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Cahoon is with the Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
Author Manuscript
Abstract Objective—This study explored the risk of patient safety events and associated nonfatal physical harms and mortality in a cohort of persons with serious mental illness. This group experiences high rates of medical comorbidity and premature mortality and may be at high risk of adverse patient safety events. Methods—Medical record review was conducted for medical-surgical hospitalizations occurring during 1994–2004 in a community-based cohort of Maryland adults with serious mental illness. Individuals were eligible if they died within 30 days of a medical-surgical hospitalization and if they also had at least one prior medical-surgical hospitalization within five years of death. All admissions took place at Maryland general hospitals. A case-crossover analysis examined the relationships among patient safety events, physical harms, and elevated likelihood of death within 30 days of hospitalization.
Author Manuscript
Results—A total of 790 hospitalizations among 253 adults were reviewed. The mean number of patient safety events per hospitalization was 5.8, and the rate of physical harms was 142 per 100 hospitalizations. The odds of physical harm were elevated in hospitalizations in which 22 of the 34 patient safety events occurred (p
