Patients tell a different story

Patients interviewed after they've left the hospital report twice as many complications as their medical records suggest, a survey has found.

"This study really shows if you talk with patients about their experiences, you find out a lot of things that don't get captured in the medical record," said study co-author Nancy Ridley, associate commissioner of the state Department of Public Health."We found adverse events that had occurred that you never would have picked up from medical records."

Based on the results, she said, Massachusetts hospitals will be encouraged to include questions about patient safety in satisfaction questionnaires they routinely send out,.

Researchers from Massachusetts General Hospital, Dana-Farber Cancer Institute, and the Department of Public Health asked just under 1,000 patients at 16 hospitals about infections, drug errors or reactions, and other incidents in a telephone survey. Their accounts were reviewed by two doctors. Then their medical records were examined by experts to see if the problems surfaced there.

More than a quarter of patients reported a problem, but only about one in 10 medical records showed anything went wrong, according to the study, which appears in tomorrow's Annals of Internal Medicine. Some of the symptoms developed after the patient left the hospital. Life-threatening or serious problems were more likely to be reflected in both the medical record and in interviews with the patient.

Over the next several months DPH's Betsy Lehman Center for Patient Safety and Medical Error Reduction will send some of the study's survey questions to hospitals and recommend they be added to an existing set of questions to pick up what medical records may not, Ridley said.

Carol Haraden, vice president of the Institute for Healthcare Improvement and a patient-safety researcher, said she wasn't surprised by the results but said they signal a clear opportunity for improvement.

"It's clear patients have more to tell us than their medical records," said "The question is how to mine this in a way that's affordable and helpful for learning."