Causes Of Medication Errors Research Articles

Atrial fibrillation treatment in Russia: work on bugs

The article discusses the results of a survey of doctors in the Russian Federation with the aim of studying approaches to the treatment of atrial fibrillation in real clinical practice and comparing the results obtained with the current clinical guidelines. Some new data are presented that could change the recommendations in the future; possible causes of medical errors and ways to correct them are discussed.

The public’s views on responsibility for medical errors in the Republic of Kazakhstan

Abstract Background Healthcare professionals, public committees and leaders, as well as and people in positions of responsibility, deeply apprehensive with improving patient safety in Kazakhstan. Patient attitude towards of medical error is relatively well studied in developed countries of the world, but little is known about Central Asian countries, especially post-soviet space. This study aimed to analyze the attitude towards medical errors, depending on whether the respondents themselves or their relatives had this experience in the Republic of Kazakhstan from 2019 to 2021. Methods The study included two hundred sixty-seven participants. The statistical analysis of data on medical error was performed for the whole country. Data on medical error from public were retrieved for the period 2019-2020. Respondents were asked about the causes of and solutions to the challenge of preventable medical errors and what the consequences of medical error should be. Results A total of 40.8% (109/267) of respondents confirmed that they had experienced problems regarding medical errors while 59.2% (158/267) had not encountered any medical errors in their life experience. Nearly one in three Kazakhstan's adults agree that cause of medical errors is lack of professional qualifications of health professionals 36.3% (97/267). The respondents noted that hospital administration 47.6% (127/267) should be held accountable for medical errors, followed by the health professionals 25.5% (68/267). Conclusions There were significant differences between the regions of the country in the causes of medical errors in the opinion of public, as well as in indicators of the degree of responsibility for and response to medical errors. There is a need for further study of the causes and attitudes of public, which may have helped to better understand the challenge of medical errors in Kazakhstan. Key messages There is a need to performing regular analysis and evaluation to find out the cause of the problem and taken into account in deciding regarding the medical error. We recommend raising awareness about medical errors and the need for incident reporting, introducing training and learning workshops, and improving medical error reporting.

بررسی فراوانی قصور متخصصان طب اوراژانس ارجاعی به پزشکی قانونی استان فارس از سال 92 تا 98

Introduction: The rise of medical errors has become a public concern among health policymakers. Due to the importance of knowing the causes of medical errors and preventing their continuation, especially in the emergency department, so this study was conducted to investigate the frequency of negligence of emergency medicine specialists referred to forensic medicine in Fars province from 2012 to 2019. Methods: The present study was a descriptive study based secondary data analysis. The study population included all negligence referred to the office of the Medical Commission of the General Directorate of Forensic Medicine of Fars Province with the subject of complaints from emergency medicine specialists during the years 2012 to 2020. The method of data collection is based on a questionnaire and the use of information in the files of the Medical Commission of the General Directorate of Forensic Medicine of Fars Province. Data collection form including patient's age, patient's education, patient's occupation, underlying illness, causes of negligence, type of treatment center, cause and motive of complaint, type of service provided, how to obtain information about negligence, location of injury, type of injury and amount of injury is. Data analysis was performed using SPSS software version 21 and descriptive Statistics. Results: Out of 92 cases, 91 were male physicians (98.9%) and 1 was a female physician (1.1%). The highest frequency of voting was in 1398 with 40 votes (43.5%) and in 1397 with 28 votes (30.4%). 54 (58.7%) of the complainants died and 19 (20.7%) had disabilities. Also, the number of complainants was improving 11 (0.12%) and improved 6 (6.5%). Of the 92 cases reviewed, 77 (83.7%) were finally acquitted and 15 (16.3%) were convicted. The highest frequency of confirmed negligence was negligence negligence 9 (9.8%) and negligence 2 (2.2%). Conclusion: The results of this study indicated that the most common cause of medical malpractice in emergency medicine specialists is negligence. Therefore, it is suggested to reduce this type of negligence by holding training workshops for emergency medicine specialists.

Medication Errors During Treatment with New Oral Anticancer Agents: Consequences for Clinical Practice Based on the AMBORA Study.

Patients treated with oral anticancer agents (e.g., kinase inhibitors) are a high-risk population for medication errors due to, for example, polymedication, age, and limited adherence. Systematic evaluations regarding frequencies and causes of medication errors and resulting harm are lacking. Our previously published multicenter randomized AMBORA trial revealed that an intensified support by clinical pharmacologists/pharmacists for patients and the treatment team considerably reduced drug-related problems and improved patient-reported outcomes. Using this database, we performed a comprehensive, additional analysis focusing on medication errors related to the patients' complete medication with consideration of the antitumor agents, concomitantly administered drugs, and herb/food intake. Two hundred two patients starting a new oral anticancer drug regardless of the tumor entity were included. Clinical pharmacologists/pharmacists performed advanced medication reviews for 12weeks. Medication errors were characterized regarding type, cause, patient harm, and the involved medicines. We detected 1.7 medication errors per patient (335/202). Of the medication errors (216/335), 64.5% occurred within the concomitant medication. Patients caused 28.4% of the medication errors. There were 67.8% detected immediately after the start of the new oral regimen, and 14.9% resulted in temporary harm. Drug-drug or drug-food interactions accounted for 24.8% of the medication errors. Patients and physicians need to be addressed in strategies for systematic reduction of medication errors during treatment with new oral antitumor drugs. Clinical decision support systems focusing on drug-drug interactions capture only a minority of the medication errors. Specialists with expertise in clinical pharmacology/pharmacy should support both the treating physicians as well as the patients for improved patient safety.

Is It Better to Disclose or Conceal Medical Error When Occur? An Indicative Study from Sohag Governorate Physicians

Introduction: Medication errors as one of the commonest medical problems in hospitals are a leading cause of patient morbidity. Subjects and methods: three hundreds (300) doctors of different degrees were asked to fulfill the attached questionnaire about medical malpractice (causes, types, preventive measures) and their opinion about disclosure or concealing the errors. Results: The studied subjects included variable age groups, with range from 25 to 65 years old. The major cause of medical malpractice reported by the participants was deficient skills 45%, followed by poor contact with patients (35%). Other reported causes are due to stress and work overload (25%). Twelve percent were due to poor team work arrangement. Only 23.7% of doctors decide to disclose their errors and 76.3% prefer to hide the medical errors. The most common error reported by participants was diagnosis errors (23.6%), and then delayed transfer in 21%. The outcome of patients secondary to error was minor in 72.6% and death occurred only in 4.67%. The most reported suggested measure (51%) for prevention of error recurrence was referral of difficult cases followed by performing risky procedures in qualified hospitals (42.6%) and then to encourage doctors to disclose their error 41.3%. Conclusion: The current study concluded that the main causes of medical errors were poor contact with patients and deficient skills. The most common mentioned errors were surgery in non-equipped place, unethical conduct and diagnosis error. The participants’ response was avoiding similar situations and increase information to prevent recurrence. The majority of participating doctors chose concealing the errors to avoid loss of reputation Recommendations: Close monitoring of residents and adequate communication between staff and regularization of duty hours can decrease occurrence o

The challenge of medication errors in the emergency department setting

Medication errors (MEs) are considered the most common medical errors and as one of the major challenges threatening the health system, which can be also reduced. MEs threaten patients' safety and may increase the length of hospital stay, lead to unexpected complications, mortality and side costs. In 2017, the World Health Organization launched Medication without Harm to reduce severe avoidable medication-related damage by 50%, globally in the next 5 years. Emergency Departments (EDs) are stressful care environments which making EDs more prone to MEs. Therefore, EDs need to be seriously considered to reduce MEs and increase patients' safety. In this regard, it is of great significance to know about the most common stage of error in pharmacotherapy, the most common type of medication error and the most common causes of MEs in the emergency department practice setting. in conclusion, the most common types of MEs in EDs include drug omission error, wrong dose and strong infusion rate. In addition, the administration and prescribing are the most common stages of MEs in EDs. Also, the most common causes of MEs in EDs in Iran include nursing shortage (fatigue) and poor medication knowledge .

Effects of a web-based education program for nurses using medical malpractice cases: A randomized controlled trial

BackgroundEducation on legal obligations in healthcare related to medical malpractice is insufficient, which has the potential to reduce patient safety. Nurses need to improve their understanding of legal obligations in order to enhance patient safety. However, no easily accessible education program has been developed that covers both the concepts of legal obligations and patient safety. ObjectiveThis study sought to develop a web-based education program using medical malpractice cases and to evaluate the effectiveness with regard to legal obligations and patient safety competency of nurses. DesignThe study design was a randomized controlled trial evaluating the effectiveness of a newly-developed web-based education program. Participants and settingSeven experts and 19 learners evaluated the developed program. One hundred eighteen nurses working in three hospitals were randomly assigned to the intervention group (N = 59) and the control group (N = 59). MethodsThe web-based program was developed using the analysis-design-development-implementation-evaluation model and evaluated by experts and learners. Data were collected from January to May 2019. The intervention was the five-week web-based education program. The post-test was conducted five weeks after the pre-test in the control and intervention groups. ResultsThe web-based program consisted of two modules on theoretical knowledge and seven modules on medical malpractice cases. The findings demonstrated significant differences in knowledge and cognition of legal obligations and patient safety competency between the control and intervention groups after the five-week intervention. ConclusionA web-based education program on medical malpractice cases enhanced nurses' awareness of legal obligations and patient safety competency. Therefore, this web-based educational program should be organized as an online continuing education program for clinical nurses. It will improve awareness of patient safety by clearly specifying the relationship between legal obligations and root causes of medical errors from various perspectives.

Evaluation of Medication Errors from the Perspective of Nurses in the ICUs of Yazd City

Introduction: Medication error is one of the most common errors in the medical context which has a great importance in the ICUs due to the patients’ inability and vulnerability in participating in the medication therapy. The aim of this study was to determine frequency, types, and reasons of medication errors in the ICUs. Methods: This was a cross-sectional descriptive study, which was conducted on 105 nurses working in the ICUs located in hospitals of Yazd City in 2017 on the basis of census sampling method. The data were collected by means of the demographic and occupational questionnaire and the medication errors questionnaire whose content validity and reliability (Alpha Cronbach's coefficient) have been approved The data were analyzed using descriptive statistics and the Chi-square statistical test through SPSS software V.16. Results: The findings revealed that %66.7 of the nurses had medication errors. %40.6 of the nurses had made medication error only once, and 58.7% of the errors occurred during the night shift. As to the injectable medications, administrating nonprescription medications, making mistakes in dosage calculation, and giving medication after discontinuation were reported with higher frequencies. Regarding the injectable medications, paying no attention to interactions of concomitant drugs, making calculation mistakes, and administrating nonprescription medications were more frequent. Also, the nurses’ fatigue was reported as the first main cause of medication errors in this study. Conclusion: Given the high frequency of medication errors) 66.7% in the last six months( particularly during the night shift as well as the nurses’ fatigue as the most important cause of the error incidences, it appears important that healthcare authorities and nursing managers take account of the approaches that enhance the nurses’ working conditions.

Handoffs in Radiology: Minimizing Communication Errors and Improving Care Transitions.

Handoffs are essential to achieving safe care transitions. In radiology practice, frequent transitions of care responsibility among clinicians, radiologists, and patients occur between moments of care such as determining protocol, imaging, interpreting, and consulting. Continuity of care is maintained across these transitions with handoffs, which are the process of communicating patient information and transferring decision-making responsibility. As a leading cause of medical error, handoffs are a major communication challenge that is exceedingly common in both diagnostic and interventional radiology practice. The frequency of handoffs in radiology underscores the importance of using evidence-based strategies to improve patient safety in the radiology department. In this article, reliability science principles and handoff improvement tools are adapted to provide radiology-focused strategies at individual, team, and organizational levels with the goal of minimizing handoff errors and improving care transitions.

Stability and Compatibility Aspects of Drugs: The Case of Selected Cephalosporins.

Intravenous drug incompatibilities are a common cause of medical errors, contributing to ineffective therapy and even life-threatening events. The co-administration of drugs must always be supported by studies confirming compatibility and thus guarantee the therapy’s safety. Particular attention should be paid to the possible incompatibilities or degradation of intravenous cephalosporins in different infusion regimens since the administration of drugs with inadequate quality may cause treatment failure. Therefore, an appropriate stability test should be performed. The study aimed to present various aspects of the stability and compatibility of five cephalosporins: cefepime (CFE), cefuroxime (CFU), ceftriaxone (CFX), ceftazidime (CFZ), and cefazoline (CFL). The degradation studies in parenteral infusion fluids and PN admixtures were conducted for CFE and CFU. The interactions between CFX or CFZ and PN admixtures, as well as the compatibility of CFL with five commercial parenteral nutrition (PN) admixtures, were investigated. The content of CFX and CFZ in PN admixture after 24 h was >90%. CFL administered simultaneously with PN admixture by the same infusion set using Y-site was compatible only with Nutriflex Lipid Special. CFE and CFU were stable in all tested infusion fluids for a minimum of 48 h and decomposed in PN admixtures during storage.

A survey of nurses' perceptions of the causes of medication errors and barriers to reporting in hospitals affiliated to Neyshabur university of medical sciences, Iran

A survey of nurses' perceptions of the causes of medication errors and barriers to reporting in hospitals affiliated to Neyshabur university of medical sciences, Iran

Medication Errors and Reducing Interventions: A Mixed Study in a Teaching Hospital

Background: Given the special importance of preventing from medication, the present study aimed to investigate the determining Causes of Medication Errors (CMEs) and their Priorities for reducing interventions in a hospital. Methods: The present mixed, sequential and cross-sectional study was conducted in a teaching hospital (2016). For data collection, Fishbone Diagrams, interviews, note taking and checklists were used, and qualitative data were analyzed though the thematic approach. Moreover, the Maxqda Software v.14.0, Excel, Edraw Max v.9.0 were employed for data analysis and reporting. Results: Seventy-five CMEs were classified under two main themes (human and non-human) and four sub-themes (personal, network, organizational, and meta-organizational). Weakness of professionalism and low experience as the personal causes; Actions of pharmacy colleagues, physicians and other nurses as the network causes; Management of nurses and unit specialty as the organizational causes and the quality of academic education, drug features and macro policies of medication as meta-organizational causes were classified. Six causes were given priority for reducing interventions. Conclusion: In the short term, human factors should be considered with the aim of reducing medication errors. It is also recommended that teaching how to deal with nurses’ stress and psychological pressure (especially beginner nurse), resulting from critically ill patients and high workload, be paid special attention. Besides, it is suggested that professionalism be given priority to reduce personal neglects and to create safe environments for reporting personal neglects. In addition, more emphasis should be placed on the right route in the process of medication administration.

Dispensing Errors in Hospital Pharmacies in Yemen: An Exploratory Study

Aims. This study aimed to describe the dispensing errors that occurred during the dispensing process in selected hospital pharmacies in Sana'a, Yemen, and to describe their types and causes. Methodology. A prospective study was carried out in selected hospital pharmacies in Yemen over 40 days using a validated tool. Results. A total of 9000 dispensed prescriptions were evaluated for the dispensing errors, and 2.13% dispensing errors were identified. Wrong dosage form (134/192), incorrect strength (24/192), wrong drug (18/192), incorrect quantity, wrong instructions written and drug available in the pharmacy but not given (6/192) and dispensing expired drugs (3/192) were the dispensing errors reported in this study. Poor handwriting, similar drug names, similar drug packaging, fatigue, heavy work, workforce issues, and poor communication were the most commonly reported causes of dispensing errors. Conclusion. There is a wide variation in the rates of prevalence of medication errors observed during this prospective study. Dispensing errors were the most common. This variation may be attributed to the nature and heterogeneity of the prescription’s sources. Study results indicate that medication errors imposed an extraordinary challenge to the healthcare system in Yemen and post significant potential harm to the patient in light of the current economic, social and security conditions. Well-designed nationwide future studies aimed at investigating the causes of medication errors to guide the design of interventions aimed at reducing their burden on the national healthcare system is highly recommended.

Perceptions of Clinical Nurses About the Causes of Medication Administration Errors: A Cross-Sectional Study.

AIMThis study was conducted to determine the perceptions of nurses about the causes of medication administration errors and the rates of reporting errors made or witnessed by them.METHODThis methodological, descriptive, multicenter, and cross-sectional study sample of this study included 590 clinical nurses working in an inpatient setting in Turkey. The data were collected using the Medication Administration Error Reporting Survey, which is a self-report questionnaire.RESULTSIn the study, it was determined that insufficient number of nurses, heavy workloads, and illegible medication orders of physicians were the most common causes leading to medication errors as stated by the nurses. Moreover, 26.1% of the nurses reported that they had made an medication error, and more than half of the nurses reported that they had witnessed medication errors. It was found that 68.8% of medication errors were not reported.CONCLUSIONIt is important to determine the nurses’ perceptions about the causes of medication errors to prevent repetition of medication errors and to establish standards for medication safety. Therefore, it may be recommended to reduce workloads of nurses and develop methods to increase the rate of reporting medication errors.

Perceptions of Nurses about Medication Errors: A Cross-Sectional Study

Purpose: The aim of this study is to assess nurses’ perception of medication errors nurses in Maternity and Child Hospital in Najran city, Saudi Arabia. Study Design: A cross-sectional study. Subjects and Methods: This descriptive study was carried out among 72 nurses in Maternity and child Hospital in Najran city, Saudi Arabia. Data were collected through a questionnaire, consisting of two parts: Part 1 covers demographical data, which includes age, gender, educational level, and years of experience and place of work in the hospital. Part 2 of the questionnaire consists of (23) questions about the nurses' perception of the causes, reporting medication error, and perceptions of barriers to reporting medication errors. Data were analyzed by using a statistical package for social science (SPSS) version 20. Results: The results of the study indicate that most of the participants had a good perception of the causes of medication errors. Nevertheless, the data analysis showed that many of the participants had reporting medication errors. More importantly, the participants indicated that there exist multiple barriers to reporting medication errors. Two-thirds of them had moderate barriers to concerns over the consequences of reporting. More than half of them had minor barriers to blaming nurses if patients are harmed, while, about one-quarter of them had major barriers to fear of punishment. There was no statistically significant relationship between the studied nurses’ perception of the causes of medication errors and their characteristics (P value > 0.05). Conclusions: It is concluded that nurses at Maternity and Child Hospital in Najran city, Saudi Arabia, Had a good perception of the causes of medication errors. In addition, there was no statistically significant relationship between the participants’ reporting medication errors and their characteristics except age and years of experience.

How to Use Quality Tools to Eliminate Medication Errors.

Background: Medication errors are errors that doctors, caregivers, pharmacists, and patients make when prescribing, using, or storing drugs. Medication errors may lead to disease in children, disease exacerbation. In the United States, medication errors cost healthcare about $ 177 billion (statistically speaking) annually. (1) The published studies estimated that about 5-10% of hospital admissions were due to the medication errors. It is suspected that approximately 3% of deaths in the Swedish population are because of the medication errors. In Canada, up to 50% of the patient safety indicates in primary care are related to medication errors. (2) Aim of the study: Attempting to prevent medication errors inside health care facilities to raise health care efficiency and maintain patient safety Methodology : Using of quality tools like brain storming, process mapping, and fish bone diagram, and the check list helped us to identify the most common causes of medication errors and finding probable solutions. (3) Conclusion: A standard protocol for the medication management must be performed to reduce medication error

A Systematized Review of Nurses’ Perceptions of Medication Errors Contributing Factors in Developing Countries

Introduction: Nurses are a main factor in maintaining the safety of a patient. Nurses are the main component and are indeed at the front of dispensing medicines to patients; they also have a responsibility to maintain the patient’s safety.
 Objective: This systematized review intends to review studies that assess and explore nurses’ attitudes and perceptions of medication errors in developing countries within the Middle East region, thereby contributing to knowledge regarding medication error risk.
 Methodology: a database search has been conducted for studies related to the research question that has been formulated using PEO framework, the database includes: MEDLINE and CINAHL EBSCO and OVID, NICE, Science Direct and ERIC. The reference lists and bibliographies were also analyzed, all the studies founded during the search process were assessed according to predefine inclusion and exclusion criteria. 10 studies (6 quantitative studies, 3 qualitative and 1 which used mixed methods) were chosen and were included in this review.
 Result: The studies assessed in this review were noted to have moderate to strong quality. The review found a range of factors that contribute to medication error, including both human and environmental factors. Among the contributing factors that most frequently mentioned inthis review were insufficient pharmacological knowledge, fatigue and overwork, communication breakdown, inadequate staff training, and high patient-to-nurse ratio.
 Conclusion and Recommendation: It would behave Saudi Arabia and neighboring countries to invest attention in this topic. Particularly advised would be additional theoretically focused research to determine the causes of medication errors.

Perceptual Gaps Between Clinicians and Technologists on Health Information Technology-Related Errors in Hospitals: Observational Study.

BackgroundHealth information technology (HIT) has been widely adopted in hospital settings, contributing to improved patient safety. However, many types of medical errors attributable to information technology (IT) have negatively impacted patient safety. The continued occurrence of many errors is a reminder that HIT software testing and validation is not adequate in ensuring errorless software functioning within the health care organization.ObjectiveThis pilot study aims to classify technology-related medical errors in a hospital setting using an expanded version of the sociotechnical framework to understand the significant differences in the perceptions of clinical and technology stakeholders regarding the potential causes of these errors. The paper also provides some recommendations to prevent future errors.MethodsMedical errors were collected from previous studies identified in leading health databases. From the main list, we selected errors that occurred in hospital settings. Semistructured interviews with 5 medical and 6 IT professionals were conducted to map the events on different dimensions of the expanded sociotechnical framework.ResultsOf the 2319 identified publications, 36 were included in the review. Of the 67 errors collected, 12 occurred in hospital settings. The classification showed the “gulf” that exists between IT and medical professionals in their perspectives on the underlying causes of medical errors. IT experts consider technology as the source of most errors and suggest solutions that are mostly technical. However, clinicians assigned the source of errors within the people, process, and contextual dimensions. For example, for the error “Copied and pasted charting in the wrong window: Before, you could not easily get into someone else’s chart accidentally...because you would have to pull the chart and open it,” medical experts highlighted contextual issues, including the number of patients a health care provider sees in a short time frame, unfamiliarity with a new electronic medical record system, nurse transitions around the time of error, and confusion due to patients having the same name. They emphasized process controls, including failure modes, as a potential fix. Technology experts, in contrast, discussed the lack of notification, poor user interface, and lack of end-user training as critical factors for this error.ConclusionsKnowledge of the dimensions of the sociotechnical framework and their interplay with other dimensions can guide the choice of ways to address medical errors. These findings lead us to conclude that designers need not only a high degree of HIT know-how but also a strong understanding of the medical processes and contextual factors. Although software development teams have historically included clinicians as business analysts or subject matter experts to bridge the gap, development teams will be better served by more immersive exposure to clinical environments, leading to better software design and implementation, and ultimately to enhanced patient safety.

Standardizing Sign-out With I-PASS Handoff in Family Medicine Residency.

Handoff miscommunications are a leading cause of medical errors. A structured handoff is an effective communication tool. We introduced the I-PASS Handoff Bundle for resident sign-out in the inpatient setting. We aimed to reduce preventable adverse events and unexpected floor calls while also improving residents' confidence and preparedness to care for patients overnight. We conducted an observational study at a single-site family medicine residency between April 2019 and March 2020. Residents received trainings in the I-PASS standardized handoff through didactic lectures and on-the-job sessions in September and November 2019. We evaluated the effectiveness of the I-PASS Handoff Bundle by comparing pre- and postimplementation data including number of medical errors and unexpected floor calls, along with residents' reported levels of preparedness and confidence to care for patients overnight. Prior to the I-PASS intervention, more than half of resident surveys included at least one unexpected floor call whereas postintervention about one-third of resident surveys included unexpected floor calls (P<.05). However, the intervention did not significantly affect residents' confidence level in caring for patients overnight and residents' rating of the usefulness of anticipatory guidance for managing night floor calls. We did not identify any medical errors related to communication issues at patient handoff within the family medicine service. I-PASS intervention significantly reduced unexpected floor calls. However, the intervention did not improve residents' reported confidence and preparedness to care for patients overnight.

Support for management medical decisions and the nature of uncertainty in them

The process of making a medical decision is characterized by a lack of knowledge and inconsistency of the available information, the lack of the possibility of attracting competent medical experts, limited time resources, incomplete or inaccurate information about the patient's condition. These aspects may be the causes of medical errors, which lead to further aggravation of the problem situation. Purpose – it is necessary to define and justify managerial medical decisions and types of medical information in conditions of uncertainty, when each variant of the sets of outcomes of the situation (recommendations) has its own unique set of values. The fundamental difference between this process for medical use is the concept of the "best medical solution", in which the key role is given to the patient's state of health in obtaining and evaluating alternatives, as well as the need to take into account the time, adverse reactions of the body and the costs of implementing this solution. In the medical field, support for medical decision-making can be classified as organizational-managerial and therapeutic-diagnostic, but both are determined by the position of the person making the medical decision and are aimed at effective management of the medical institution as a whole. The article describes the causes and factors of the nature of uncertainty in the tasks of supporting medical decision-making in medical-diagnostic and organizational-managerial areas. The analysis of the features of supporting medical decision-making in conditions of uncertainty is carried out. Approaches and directions in this area, as well as the concept of “solution”, are considered. The essence of the management medical decision is reflected. The classification of management medical decisions is given, the requirements that are imposed on them are highlighted. The features of the development of management medical solutions in the conditions of incompleteness and uncertainty, the problems that arise when they are implemented in information systems are presented. The general scheme of the process of creating a management medical solution is shown. The features of making group and individual decisions are reflected. The algorithm of actions of the person making the medical decision in the conditions of uncertainty, incompleteness and risk in medical subject areas is presented.