Definition of Medical Error
Medical error is best defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim. 1, 2
Understanding Medical Error
The Institute of Medicine's seminal report "To Err is Human: Building a Safer Health System" established this definition, which has been widely adopted across healthcare systems 1. This definition is particularly valuable because:
- It focuses on the process rather than the outcome
- It captures both errors of execution (failure to complete a planned action) and errors of planning (use of a wrong plan)
- It does not require harm to have occurred for an error to be recognized
Key Distinctions Between Related Terms
It's important to distinguish medical error from other related concepts:
Medical Error: Failure of a planned action or use of a wrong plan 1
Adverse Event: An injury resulting from medical intervention rather than the patient's underlying condition 1
Medical Negligence: A subset of errors where the care provided falls below the accepted standard of practice 1
Medication Side Effect: An unintended and undesired effect of a medication that is not related to errors of administration 2
Why This Definition Matters
The definition focusing on process failure rather than outcome is critical because:
- It allows for identification of errors even when they don't cause harm (near misses)
- It supports a systems approach to error prevention
- It aligns with modern patient safety frameworks that emphasize proactive identification of risks
The European Society of Intensive Care Medicine and the American Academy of Pediatrics both support this process-focused definition 1, recognizing that errors can occur without causing harm, and not all adverse outcomes are the result of errors.
Implications for Patient Safety
Understanding medical errors as process failures rather than simply adverse outcomes has important implications:
- Error Reporting: Encourages reporting of all process failures, not just those that cause harm 2
- System Improvement: Focuses attention on system vulnerabilities that can be addressed 1
- Culture of Safety: Supports a just culture approach rather than blame-focused responses 2
Common Types of Medical Errors
Medical errors can be classified into several categories:
- Medication Errors: Errors in ordering, dispensing, or administering medications
- Diagnostic Errors: Delays, missed, or incorrect diagnoses
- Communication Errors: Failures in communication among healthcare teams
- Management Plan Errors: Errors in planned treatment or intervention 2
Prevention Strategies
The American Academy of Pediatrics recommends several approaches to prevent medical errors:
- Implementing standardized protocols and communication tools
- Fostering a culture of safety that encourages error reporting
- Utilizing technology to flag potential errors
- Creating systems with built-in redundancies 1, 2
By understanding medical errors as process failures rather than simply adverse outcomes, healthcare systems can more effectively identify vulnerabilities and implement preventive strategies to improve patient safety.