Ambulatory setting, outpatients

Reporting Events in Ambulatory Care Settings

Prevalence of Adverse Events

Although ambulatory care is the most-often used care setting for health services, determining the prevalence of adverse events in this setting is much more nuanced and challenging than hospital, surgical, or even long-term care settings. Unlike inpatient or residential care settings, medical errors in ambulatory care tend to:

• Be subtle in nature

• Not result in immediate harm, or may even take years for results of harm to appear

• Involve actions or inaction and patient adherence issues, which can be difficult to monitor

• Occur after the patient has left the facility, making the adverse event difficult to track.

Additionally, ambulatory care settings often lack the level of resources afforded to hospital settings, such as onsite diagnostic testing services and clinical specialists, which can create gaps in care if test-tracking and follow-up is not optimized. Research suggests that outpatient diagnostic errors effect approximately 12 million U.S. adults every year—a 5.08% error rate—about half of which are estimated to be potentially harmful.

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