Daren K. Heyland|Roy Ilan|Xuran Jiang|John J. You|Peter Dodek
The prevalence of medical error related to end-of-life communication in Canadian hospitals: results of a multicentre observational study
Queen's University|Queen's University|Kingston General Hospital|McMaster University|University of British Columbia|Centre for Health Evaluation and Outcome Sciences
h3backgroundh3 hospital setting inadequate engagement healthcare professionals seriously ill patients families regarding endoflife decisions common problem may lead medical orders lifesustaining treatments inconsistent patient preferences prevalence patient safety problem previously described h3methodsh3 using data multiinstitutional audit quantified mismatch patients family members expressed preferences care orders lifesustaining treatments recruited seriously ill elderly medical patients andor family members participate audit considered medical error patient preferred resuscitated orders undergo resuscitation overtreatment patient preferred resuscitation cardiopulmonary resuscitation cpr orders resuscitated undertreatment h3resultsh3 16 hospitals canada 808 patients 631 family members included study comparing expressed preferences documented orders use cpr 37 patients experienced medical error patients 8 2 expressed preference cpr cpr withheld documented medical orders undertreatment patients preferred cpr 174 35 orders receive overtreatment considerable variability overtreatment rates across sites range 1482 patients frail less likely overtreated patients participating family member likely overtreated h3conclusionsh3 medical errors related use lifesustaining treatments common internal medicine wards many patients risk receiving inappropriate endoflife care