Medical errors in a hospital in Taiwan: Incidence, aetiology and proposed solutions

Objective: To investigate the incidence and aetiology of medical errors in a hospital in Taiwan and to propose effective solutions for their prevention. Design: Retrospective audit. Setting: An 800 bed general hospital in Taiwan with a computerised physician order entry system and prescription delivery system. Methods: We collected and analysed 1,462 filed incident reports covering the period 1 January 2001 to 31 December 2002. Errors were categorised into one of three types: medication, medical or administration errors. They were further analysed to see if they resulted in patient harm. Medication errors were also further analysed to identify the type of error. Results: The number of medication, medical and administration errors were 254 (17.3%), 736 (50.4%) and 472 (32.3%), respectively. Based on the number of patients treated in the hospital and the number of prescriptions written, the calculated medical error rate was less than 0.1% and the medication error rate was less than 0.01%. 8% of incidents resulted in injury to patients. The most common medication errors were omitted drug, wrong drug and wrong dose. Conclusions: Compared with other studies, the medical and medication error rates in this study are very low. This may be a reflection of the benefits of computerised physician order entry and prescription delivery, but may also be due to under-reporting.