Patient safety | aad.org

Patient safety

The Academy is dedicated to improving patient safety in the clinical setting. The AAD’s Patient Safety and Quality Committee leads efforts to promote patient safety education to encourage members to practice even safer and higher-quality medicine. The following resources document patient safety challenges in medicine as a whole and in dermatology specifically, and highlight opportunities to learn more about this vital topic.

Patient safety in medicine

In its landmark 1999 publication, “To Err Is Human,” the Institute of Medicine defines patient safety as "freedom from accidental injury." Although the staffs of hospitals, clinics, and doctors’ offices take many steps to keep their patients safe, medical errors can happen. According to the Institute for Healthcare Improvement, medical errors — also known as adverse events — occur when there is a single misstep in a chain of activities.

At the National Patient Safety Foundation, researchers have identified a number of ongoing patient safety challenges in medicine as a whole. Chief among them are:

  • Wrong-site surgery.
  • Medication errors.
  • Health-care-acquired infections.
  • Falls.
  • Readmissions.
  • Diagnostic failures.

Patient safety in dermatology

Malpractice data are good indicators of the most common medical errors. According to the 2009 JAAD article, “Patient Safety: Part I. Patient Safety and the Dermatologist,” the number of closed claims against dermatologists are few. They have remained relatively constant for more than 20 years, with a range from about 86 to 123 per year. Additionally, the proportion of dermatologists facing claims is among the lowest of all specialties, according to the article, “Malpractice Risk According to Physician Specialty,” in the New England Journal of Medicine. Some of the most common procedural errors cited in claims against dermatologists are:

  • Improper performance.
  • Error in diagnosis.
  • Medication errors.
  • Failure to supervise or monitor.
  • Performed when not indicated.
  • Failure to instruct or communicate with patient.
  • Failure to recognize a complication of treatment.
  • Improper supervision of residents or staff.

From 1985-2006, the most common diagnoses in malpractice claims against dermatologists were:

  • Malignant neoplasms.
  • Acne dyschromia.
  • Psoriasis.
  • Malignant melanoma.
  • Contact dermatitis and eczema.
  • Benign neoplasm.
  • Viral warts.
  • Disorder of the skin and subcutaneous tissue (not otherwise specified).
  • Diseases of the nails.

Recommended reading

Explore the following resources to get a deeper look at patient safety in dermatology practices.