Patient safety may suffer at busy hospitals

NEW YORK, May 5 (Reuters) At hospitals already running at full or over capacity, busy admission days and inadequate staff may raise the risk of adverse events that injure patients, according to report published this month.

''While financial and political pressures to make healthcare more efficient are leading to increased hospital occupancy and greater patient turnover, patients and policymakers are quite rightly demanding that health delivery systems be made safer,'' lead author Dr. Joel Weissman, from Massachusetts General Hospital in Boston, said in a statement.

''Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,'' he added.

The findings stem from an analysis of outcomes for 6,841 patients who were discharged between October 2000 and September 2001 from two urban and two suburban teaching hospitals in the US.

Weissman's team assessed the daily workload of each hospital and catalogued adverse events by searching patient records for injuries that could be the result of the care received (not a result of a patient's underlying condition), such as wound infection, mishaps during or after surgery, and falls. In total, 1,530 adverse patient events were identified.

The authors found that one of the urban centers had particularly high occupancy rates. Throughout much of the 1-year study period, this hospital was operating at or beyond its designated capacity.

At this high-occupancy center, admissions and the patient-to-nurse ratio were directly linked to the adverse event rate. For example, for each 10 per cent rise in the patient-to-nurse ratio, the adverse event rate rose 28 per cent.

By contrast, these workload variables had little effect on risk at the other three hospitals with lower occupancy rates.

''These data suggest that high workload may be risky at organizations with little slack, and suggest that administrators should adopt an array of measures to try to minimize risk under these circumstances,'' Weissman and colleagues conclude.

REUTERS SYU KN0905