Large cohort study shows mild increase in hospital-acquired conditions for July admissions versus those in other months.J Hosp Med. 2015 Mar 31; [Epub ahead of print].
The July effect: an analysis of never events in the nationwide inpatient sample.
Wen T, Attenello FJ, Wu B, Ng A, Cen SY, Mack WJ. J Hosp Med. 2015 Mar 31; [Epub ahead of print].Whether the "July effect"—a period of increased risks due to the introduction of new interns and residents at hospitals—is a real phenomenon or merely a myth has been long debated. Prior studies have largely been mixed, although a systematic review concluded that the weight of the evidence suggests increased mortality during this annual workforce transition. This retrospective cohort study used the AHRQ-maintained nationwide inpatient sample database to examine hospital-acquired conditions, which are considered to benever events. Of the nearly 145 million admissions recorded across 4 years, hospital-acquired conditions occurred in 4.7% of hospitalizations overall, while patients admitted in July had an incidence of 4.9%. July admissions were linked to a 6% increased likelihood of experiencing a hospital-acquired condition, with multivariate analysis corrections. Hospital-acquired conditions, which represent preventable complications, are likely a more sensitive marker for hospital quality and safety than mortality. A prior AHRQ WebM&Mcommentary explored the implications of the July effect through discussing a case of iatrogenic hypoglycemia (a never event) related to a new intern's lack of experience.
Impact of diagnosis-timing indicators on measures of safety, comorbidity, and case mix groupings from administrative data sources.
Naessens JM, Campbell CR, Berg B, Williams AR, Culbertson R. Med Care. 2007;45:781-788.
Never events: Utah hospitals saw nearly 60 serious errors in 2007.
May H. Salt Lake Tribune. August 18, 2008.
Adverse Events in Hospitals: Care Study of Incidence Among Medicare Beneficiaries in Two Selected Counties.
Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; December 2008. Report No. OEI-06-08-00220.
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Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2009.
Oakbrook Terrace, IL: The Joint Commission; January 2010.