Important determinants to whether or not an adverse medical event has occurred

When adverse medical events occur, there can be many determinants as to their happening.  Factors such as protocol compliance, staffing and safety levels and even patient perception can play a role in the uncovering of, or contribution to, an adverse medical event.  However, if an unfavorable event should occur, some such determinants may be considered more important than others. 

It is one’s opinion that the factor of patient perception is important when determining if an unfortunate medical event has happened; however it is not the most important.  On one hand, the patient’s intuition may tell them that something is wrong, for instance, internally.  In a major mishap, perhaps a surgical instrument was left in the patient.  In a situation like this, the patient perception can play a huge role in the determination of error.  However, on the other hand, some patients may have a cognitive illness and therefore not be a legitimate source of perception.  Thus, one feels that when using patient perspective as a motivator, for examining a possible adverse event, it should be approached on a case-by-case basis.

One factor that can be deemed as more important than patient perception is protocol compliance.  Following protocol, for example, in a surgery, is important each and every single time a surgery is performed.  If a protocol checklist is not completed after a procedure, situations such as instruments being left in patients can occur.  The checklist can be a huge indicator of something having adversely occurred.

Another determinant that may be considered more important than patient perception is the level of safety that is enacted within an organization.  Clearly if safety is not at optimal levels, accidents can occur.  For example, if bed linens or physician robes are not cleaned daily, they can be breeding grounds for infectious bacteria.  Implementing a checklist and keeping track of it can be a very important determinant as to whether all safety measures are being used when re-using materials.

A last, but certainly not least, example of an important determinant as to whether or not an adverse medical event has occurred is the level of staff that is present during such an event.  To exemplify, ensuring that the proper amount of nurses are always available in the intensive care unit and controlling for their presence can prevent a disastrous event from taking place.  If such an event should occur, having controls will give an insight into where a mistake has taken place.

Overall, there are many, many determinants that can be reliable indicators as to whether or not an unfavorable event has occurred.  Patient perception is one of those, however there are others that can be considered more important.  Listening to patients and respecting their thoughts is always good practice; yet taking their overall situation into consideration, when entertaining a move toward investigation of an adverse event, is even better practice.