Medical errors remain a problem despite years of effort

By | July 31, 2014

I recently read an article at Senator Bernie Sanders website about preventable medication errors. The article lists preventable medical errors in hospitals as the third leading cause of death in the U.S. behind only heart disease and cancer.

The article goes on to say that “the Journal of Patient Safety recently published a study which concluded that as many as 440,000 people die each year from preventable medical errors in hospitals. Tens of thousands also die from preventable mistakes outside hospitals, such as deaths from missed diagnoses or because of injuries from medications.” I’m not exactly sure what article they’re referencing here as they didn’t provide a link or additional information, but I assume they’re referring to the article by James in September 2013. Just a guess, I could be wrong.1 Regardless of the actual reference, the bottom line is that the number of patients that die from preventable medical errors is high.

Additional information presented in the article:

  • 2010 Department of Health and Human Services report that cited 180,000 Medicare patients die each year from preventable adverse events in the hospital.
  • 2011 Centers for Disease Control and Prevention report that cited 1-in-25 hospital patients get an infection from being in the hospital; 700,000 become ill of which 75,000 die.
  • 2011 study putting the cost of medical errors at $17 billion a year (no reference mentioned).
  • 2012 Journal of Health Care Finance article citing the total cost at $1 trillion when including things like lost productivity due to missed work days.

Progress in patient safety appears to have eluded us over the years. Healthcare has spent countless hours, and an unimaginable amout of money on patient safety, and yet we continue to see numbers like this. Why? What’s the rate limiting step in improving patient safety? That’s the ultimate question.

Do additional rules and regulation prevent patient harm? It’s hard to say as I don’t think anyone has bothered to go back 10 years and take a look. I don’t think the introduction of additional regulation is the answer. In fact, I believe the opposite is true. I believe that increased regulatory requirements create a hectic environment with bloated administrative costs. I experienced this during the last few years I practiced in a hospital. We were constantly dealing with new regulation. It never seemed to help anything, but always got in the way of my job.

What about technology? We’ve certainly seen advances in technology over the years.  In a vacuum, the explosion of new technology has created a safer patient care environment. Bar code scanning, automated dispensing systems, clinical information systems, robotics, mobile applications and sensors, and so on have all been used to improve patient care. However, it’s unclear what impact these technologies will have long term because of their poor integration and lack of standardized workflows. Perhaps the introduction of technology has slowly taken our attention away from the patient. Many of the technologies I’ve seen throughout healthcare systems have done little to free up providers to spend more time with patients. It’s likely that some of the technology has created an even wider gap between provider and patient. That can’t be good for decreasing errors.

The increased complexity of patients, the introduction of new medications and procedures, the desire to cut care costs without doing the same for administrative costs, and the inability for healthcare to drive wide sweeping changes quickly is certain to cause more harm than good. The unfortunate consequences of such a system has created long waits for care and the unwillingness for healthcare system to share information and cooperate with one another. Neither of which can be cited as methods for decreasing errors.

We speak of patient centered care, but I don’t believe that’s what we’re providing. I have witnessed this firsthand as I help my mother navigate the complexities of our broken healthcare system. This experience has led many patients to become advocates by becoming more involved in their own care, which has been good for healthcare overall. However, the inability for some that lack the ability to do the same has created an increasingly wide gap in their care.

Preventable medication errors by definition shouldn’t happen, but they do. And based on what I’ve experienced firsthand as both a pharmacist and a patient advocate for my mother leads me to believe they’ll be around for quite some time to come.

———————————————————————

1. James JT. A new, evidence-based estimate of patient harm associated with hospital care. J Patient Saf. 2013;9(3):122–128.

One thought on “Medical errors remain a problem despite years of effort

  1. John Poikonen

    One of your best posts…. thanks for the summary and article.

    One quick item:
    Why do pilots use checklists, but not physicians? Cause pilots are in the same plane as their patients.

    I was having some surgery recently (shattered radius from a bike crash). I mention the checklist manifesto and above dumb joke. The entire OR team surrounds my gurney and starts with their extensive check lists. It was hilarious…. (had to be there).

    My point — There is hope.

Leave a Reply

Your email address will not be published. Required fields are marked *