Summaries of Independent Scientist (K) Awards

Weingart, Saul

Institution: Dana Farber Cancer Institute, Boston
Grant Title: Partnering with Patients to Find Adverse Events
Grant Number:  K08 HS011644
Duration: 5 years (2001-2006)
Total Award: $549,900

Project Description: This project had three main goals:

1. Assess whether hospitalized patients and their families can identify adverse events and medical errors, to characterize the epidemiology of patient-reported events and errors, and to compare patient-reported events with the results of other methods.
2. Assess whether ambulatory patients can identify adverse drug events (ADEs) and medication errors in response to automatic electronic queries, to characterize the epidemiology of patient-reported ADEs and medication errors, and to understand whether patient ADE reporting results in timely and appropriate responses by primary care physicians.
3. Examine whether hospital performance on a consumer survey of quality health care correlates with surgical complication rates.

Career Goals: Dr. Weingart is the Vice President for Patient Safety at the Dana-Farber Cancer Institute and Associate Professor of Medicine at the Harvard Medical School.  He earned his Ph.D. in Public Policy from Harvard followed by his M.D. from the University of Rochester.  He served his General Medicine residency at Beth Israel Deaconess Medical Center in Boston.  The former grantee continues to conduct health services research in the field of patient safety.

Progress to Date: This grant has been completed.  The implication of this series of studies was to demonstrate that hospitalized patients can provide information about adverse events and quality of care that is not captured through usual research methods (such as chart review) or administrative tools (such as hospital incident reports).  In addition, the relationship between service quality and patient safety may offer a promising area of future investigation.  If the safety climate in an organization supports effective communication and efficient care, this may manifest itself as favorable patient ratings of service quality as well as fewer medical errors and preventable adverse events.  In addition, the lesions from inpatient care appear to hold in the ambulatory setting.  Using E-mail prompts via a patient Internet portal, adult primary care patient can (and did) report medication-related symptoms including adverse drug events.  Electronic medication safety reminders prompted a meaningful dialogue between patients and their clinicians, addressing a variety of issues and potential problems in medication safety.

Highlights and Specific Accomplishments:

• Recipient of the Price Waterhouse Cooper Lectureship, Hospital for Sick Children, Toronto, Ontario, 2004.
• Member of the Society of General Medicine.

K-Generated Publications (selected): 

Weingart SN, Toth M, Sands DZ, et al.  Physicians' decision to override computerized drug alerts in primary care.  Archives of Internal Medicine 2003. 163:2625-31.

Weingart SN, Seeing error through new lenses [editorial]. Journal of General Internal Medicine 2003. 18:675-676.

Weingart SN, Iezzoni LI.  Looking for medical injuries where the light is bright [editorial].  JAMA 2003. 290:1917-1919.

Weingart SN, Farbstein K, Davis RB, Phillips RS.  Examining the safety culture: a multi-hospital survey.  Joint Commission Journal on Quality and Patient Safety 2004. 30:125-132

Weingart SN, Toth M, Eneman J, et al. lessons from a patient partnership intervention to prevent adverse drug events. International Journal for Quality in Health Care 2004. 16(6):499-507.

Weingart SN, Ragovick O, Sands DZ, et al. What can hospitalized patients tell us about adverse events? Learning from patient-reported incidents. Journal of General Internal Medicine 2005. 20:830-6.

Weingart SN, Flug J, Brouillard D, et al. Oral chemotherapy safety practices at U.S. cancer centres: Questionnaire survey. British Medical Journal 2007. 334:407-09.

Taylor B, Marcantonio ER, Pagovich O, Carbo A, Bergmann M, Davis RB, Bates DW, Phillips RS, Weingart SN. Do medical inpatients who report poor service quality experience more adverse events and medical errors?  Medical Care 2008. 46:224-28.

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