Understanding Clinical Error

Clinical error can be broadly defined as any error in conduct or judgement in the clinical environment, irrespective of the whether or not the error produces or is the main cause of an adverse event. Experts estimate that at least 50% of clinical error is avoidable.

In 2007:

  • 8.7% of admissions had at least one adverse event
  • 15% of adverse events resulted in impairment or disability which lasted >6 months
  • 10% contributed to patient death
  • Increased mean length of stay of 8 days

Around 900,000 patients (10%) were affected by an adverse event that put their safety at risk. At a cost of around £2 billion in increased length of hospital stay. Whilst these are crude figures, they gives some indication of the frequency of the problem at a local level [2].

How and why do clinical errors occur?

Clinical errors are caused by human error and equipment faults – with human error being responsible for about 60 – 70% of clinical errors.

We are fallible and we make mistakes, in healthcare the consequences of these mistakes can be catastrophic.

Human error can occur because of limits to performance in:

  • Wellbeing
  • Cognitive error
  • Over/ underestimate abilities
  • Situation analysis

Other factors that can cause error:

  • Environment
  • Workload
  • Organisational culture