• Are we most interested in focusing on medication errors for inpatient settings that lead to patient injury (ADEs)? If yes, review the methods described in Table 5-1.

  • Are we interested in detecting as many errors as possible for inpatient settings so that real system problems can be identified more quickly and prevention efforts prioritized? If yes, review the methods described in Table 5-2.

  • ADE and error detection methods for outpatient settings are summarized in Table 5-3.

Some of the methods available for detecting errors and ADEs are described in greater detail below. These include reporting, chart review, computerized detection of ADEs (Classen et al., 1991; Evans et al., 1991; Bates et al., 2003), observation of medication administration (Barker et al., 2002),

TABLE 5-1 ADE Detection Methods: Inpatient Setting

Detection Method


Source of Data

Chart review (see Morimoto et al., 2004)

Data sources are screened for evidence that an ADE occurred

Medical record (including electronic notes), orders

Computer-generated signals

Computer screens orders, laboratory values, and other data for indicators that an ADE may have occurred; reviewer follows up on results

Triggers from computerized data (e.g., laboratory results, order for antidote)

Electronic notes

Software screens chart for evidence of an ADE; reviewer follows up on results

Electronic health record, discharge summaries (Murff et al., 2003)

Self-report, voluntary

Providers submit data about events

Patients, medical record

Self-report, prompted

Providers are interviewed to see whether any incidents have occurred


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