Fatigue is one of the major causes of adverse events (AE) in hospitals, according to research. Relieving healthcare professionals of non-core tasks can help to a great extent.

1. Outsourced Strategies International 1-800-670-2809
The Adverse Event Scenario –
Medical Outsourcing Can Help
According to research findings published in the
Patient Safety in Surgery journal, adverse
events (AEs) occurring
after operations must be
documented efficiently
and their severity
determined for hospitals
to correctly identify
needs for patient safety
and create specific
interventions to improve
the care. Fatigue seems
to be the major contributory factor of adverse
events following surgery or treatment and is a
result of human error in
medical intervention.
Human errors can be
caused by systems
failures such as poor
management decisions,
poor communications,
insufficient resources,
poor staffing, poor
documentation, or a lack
of safeguards and check points. Technical
mistakes and the inability to deal with the

2. Outsourced Strategies International 1-800-670-2809
complexities or demands of the healthcare
system can also cause medical errors. It has
been found that medical outsourcing of non-
core tasks can help to a great extent.
The Adverse Events Statistics
The study covered three hospitals in the
Midwest that are part of an integrated
healthcare system. Data was examined from
2006 till 2009 for the reported AE rates
covering 96 categories which were classified
according to type, patient age and severity.
The researchers discovered that of the 82,784
hospitalizations, at least a single surgical
procedure and one AE was reported in 6.5% of
the hospitalizations, which amounted to 5,368
cases. The mean AE rate among the surgical
procedure groups was 82.8 per 1000
hospitalizations. In surgical categories, though,
the AE rate was as high as 555.7 per 1000 for
operations performed on the pericardium and
heart. AEs most commonly included care
management. Medication events were next,
followed by invasive procedures.
Electronic reporting systems have been
developed by healthcare facilities to identify

3. Outsourced Strategies International 1-800-670-2809
and promptly report AEs which eventually
leads to measures for improving patient safety.
This study has been comprehensive in
analyzing systematically the AE rate variations
in various kinds of surgery. It has also
specifically identified particular AE types which
are the most common in each of the surgical
categories. The study also helps identify AE
category severity levels.
Fatigue – the Primary Culprit
It has been reported that fatigue is the reason
for over 1600 events that have been reported
to the PPSA (Pennsylvania Patient Safety
Authority). Thirty seven of these cases were
adverse events, and four of these adverse
events also led to the death of the patients.
Most of the fatigue related events were caused
by errors in medication or mistakes in
connection with any procedure. The study also
discovered that nurses working for more than
12.5 hours have a greater chance of incurring
fatigue because of which mistakes could occur.
But PPSA also claims that efforts are also being
made to reduce the working hours of nurses
and other medical staff, though deeper and
more extensive measures needed to be carried

4. Outsourced Strategies International 1-800-670-2809
out as fatigue cannot be addressed by reducing
the working hours alone.
How Fatigued Staff Pose Major Risk
Fatigued medical staff, as in other industries,
could display features such as attention lapses,
problems with focus, reduced motivation,
confusion, inefficient problem solving, memory
lapses, irritability, loss of empathy, flawed
communication, etc. Studies with nurses
revealed that working overtime or in 12-hour
work shifts could result in difficulties in
remaining awake and alert during duty hours.
The risk of errors is therefore three times
greater. Working 12.5 hours or more posed the
highest risk.
Grim Reminder of What Fatigue Could Do
A classic case of fatigue was reported of a
Wisconsin-registered nurse in 2006. She was
charged with class H felony for mistakenly
administering an epidural medication to a
patient in place of the antibiotic prescribed. On
investigating the Wisconsin Department of
Regulation and Licensing records, it emerged
that the nurse was on two consecutive eight-
hour shifts which ended on the midnight of the

5. Outsourced Strategies International 1-800-670-2809
day of the incident following which she was
scheduled to join for the next eight-hour shift
in the morning at 7 AM.
How Medical Outsourcing Can Help
Fatigue seems to be the major contributory
factor of adverse events following surgery or
treatment. Much of this can be avoided
through medical outsourcing of non-core
tasks such as medical coding, billing, A/R
collections, forms processing, transcription,
and so on. With a professional team handling
these tasks, healthcare providers can focus
better on what they do and avoid causing
unintentional harm to patients.