Identifying Vulnerable Patients at Heightened Risk for Medical Error

Practices, such as isolation precautions, that change workflow processes may have unintended consequences that increase patients’ risk.

The Institute of Medicine Report To Err Is Human,¹ published in 2000, estimates that medical error contributes annually to 44 000 to 98 000 deaths in the United States among inpatients alone. Subsequent attempts to measure gains in the safety of health care delivery have not resulted in any significant progress.^2,–5 Although several specific populations of patients have garnered increased attention, including intensive care unit (ICU) patients, most discussions on patient safety and medical error focus on understanding specific types of events (eg, medication error) or care processes (eg, hand offs) rather than on population characteristics. Patient- and population-level risk factors are relevant to understanding and preventing medical error.^6,7 

In this article, I describe selected populations of patients relevant to nurses who practice in diverse...