Hospitals Are Not Getting Safer
Nearly 15 years ago, the Institute of Medicine report “To Err is Human” drew attention to the disturbing number of preventable deaths in hospitals.
According to recent testimony by a panel of patient safety leaders to the Senate Subcommittee on Primary Health and Aging, there has been little progress in addressing this issue in the 15 years since, despite all of the increased regulations. In fact, preventable medical errors in hospitals are now the third leading cause of death in the US, only after heart disease and cancer.
“The problem of patients dying or being harmed because of preventable medical errors in U.S. hospitals remains [a] grave consequence that is not getting enough attention,” according to the Senate subcommittee chairman.
There are five main types of preventable medical errors. The question is, who in our industry is watching out for these errors, and where does responsibility for oversight end and begin?
- Errors of omission: Provider fails to perform an obvious, necessary action, like prescribing a certain medication.
- Errors of commission: A mistaken action harms a patient, like surgery on the wrong body part.
- Errors of communication: Miscommunication or failed communication between providers, or between a provider(s) and patient, such as a failure to warn a patient about the risks of certain activities.
- Errors of context: Provider does not account for the unique constraints in a patient’s life, like not having reasonable access to follow-up care.
- Diagnostic errors: Harm to the patient resulting from delayed, wrong, ineffective, or no treatment.
A recent study by Patient Safety America estimated that the 98,000 preventable error deaths cited in the Institute of Medicine’s original 2000 report may have been severely understated, and the real number could be closer to 440,000 deaths annually.
That is roughly equivalent to 148 September 11th attacks every year.
In fact, preventable medical errors in hospitals are now the third leading cause of death in the US, only after heart disease and cancer.
This is only preventable deaths. It doesn’t include infections and sickness that did not result in death.
Even without human error, the potential for hospital-acquired infections is immense. There are thousands of patients coughing and touching furnishings and other items, which are then touched by relatives and staff. It is almost impossible to prevent the spread of disease and infection in this environment.
And this doesn’t even factor in issues of inappropriate treatment, over-treatment, over-medication, or unnecessary surgeries, which can result in a poor prognosis for individuals who may already be in fragile health.
I am not a big fan of politicizing an issue, but this transcends politics. Hospitals attract the sickest of the sick people. That is what they are there for, but we as an industry need to focus on reducing the potential for preventable deaths in hospitals.
We need to focus on directing people to healthier options — whether non-surgical alternatives, the best providers, or non-hospital based surgeries and treatment.
We may never know when our actions prevent a health complication, or even death, but any time we can lower a patient’s risk, everyone is better off.