Articles Tagged with “medical mistakes”

In 1999, the Institute of Medicine reported a stunning figure: Each year, up to 98,000 people were dying in U.S. hospitals. These people were not dying from the illness that brought them to a hospital, but from medical mistakes which happened during treatment there.

Over the years, there have been signs the number may be greater. One came in 2010, when the Office of Inspector General for Health and Human Services reported that hospital mistakes contributed to the deaths of 180,000 Medicare patients in just one year.

Now, a new study published in the Journal of Patient Safety reports between 210,000 and 440,000 patients each year suffer some type of preventable harm that contributes to their death. These harms may include patients getting the wrong medicine, surgical errors, or infections resulting when safety procedures are not followed. That makes medical malpractice the third leading cause of deaths in the U.S., following heart disease and cancer.

It is hard to imagine that experienced surgeons, anesthesiologists and nurses would need a checklist to avoid obvious mistakes in surgical procedures, but the hard evidence is that simple checklists make an enormous difference in patient outcomes. Complications and medical malpractice rates are cut dramatically. The evolution of the checklist is chronicled in a recent book by Boston surgeon Atul Gawande. books[1].jpg

In his book, The Checklist Manifesto (Metropoliltan Books 2009), Dr. Gawande, who practices at the Brigham & Women’s Hospital in Boston, points out that the average American has seven operations in his or her lifetime; that there are fifty million operations performed every year; and that there are “upwards of 150,000 deaths following surgery every year–more than three times the number of road fatalities.” And, research has shown, “at least half our deaths and complications are avoidable.”
Inspiration for the procedural checklists for surgery came from the airline industry, which has always used checklists for routine and emergency procedures. Thousands of hours are spent honing the lists so they are not overwhelmingly detailed and difficult to follow. And they work.
Working with the World Health Organization, Dr. Gawande and the research team studied complication rates in a variety of hospitals around the world, some teaching institutions in wealthy countries, some from the most impoverished countries, and some in between. Complications and deaths were assessed. The checklist was implemented and changes were studied. Within months, major complications had dropped by 35% and deaths had dropped by 47%.
The 19-point checklists now in use include some remarkably simple steps: The operating room personnel introduce themselves and state their roles; they discuss any known risk factors; they make sure they have the right patient, the right procedure, and the right part of the body. The list also includes more details such as confirming medication allergies, reviewing the anesthesia plan, discussing concerns about blood loss, identifying pathology specimens, confirming sponge and needle counts, and sending important information to the recovery room.
These simple procedures have saved lives, reduced complications, and saved probably hundreds of millions of dollars and immeasurable pain and suffering. A checklist that costs almost nothing to perform (just a few minutes of everybody’s time) is easily saving far more than any possible medical malpractice “reform” that is being considered in the halls of Congress or state houses around the country.  Further fine-tuning of medical practices, not punishing the injured, is the correct path to malpractice reform.
Advice to Consumers: If you are planning for a surgical procedure, make sure your surgical team is using a checklist to avoid complications in your case. According to Dr. Gawande, over 94% of medical professionals say they would want a checklist for themselves.

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stethoscope.jpgA comprehensive study into hospital care found serious and fatal medical errors are occurring at the same rate, despite new programs implemented to improve patient safety.

The study analyzed patient care in 10 North Carolina hospitals from 2002 to 2007 and found no decrease in medicine errors, hospital-acquired infections and other medical mistakes. The study is said to be one of the most thorough assessments into patient safety since 1999, when the Institute of Medicine released a report that found medical mistakes caused 98,000 deaths and over 1 million injuries annually in the United States.

The study will be published this week in The New England Journal of Medicine. The research team focused on North Carolina hospitals because compared to other states, it has seen more patient safety initiatives. But the study still found medical errors and medical malpractice in a large number of cases.

The study reviewed records of 2,341 patients admitted to the hospitals and found 18 percent had been harmed by medical malpractice, some more than once.

Of these, 63.1 percent of injuries were preventable and 2.9 percent of patients suffered permanent injury, such as brain damage. Some 2.4 percent of medical errors caused or contributed to the patient’s wrongful death.

Medical errors also increased costs by extending hospital stays for 42.7 percent of patients.

Medication errors caused 162 problems. Computerized systems for ordering medication can eliminate up to 80 percent of errors, the study’s author, Dr. Christopher P. Landrigan of Harvard Medical School told The New York Times. Only 17 percent of hospitals use these systems.

But Landrigan said the number of medical errors is likely even greater than his study revealed because patient reporting is voluntary. He called for a monitoring system at the federal level to identify more mistakes.

The study further noted that many problems were caused by the hospitals’ failure to use measures designed to prevent mistakes and wrongful deaths. Landrigan said safety protocols and checklists are fundamental to improving safety.

“Until there is a more coordinated effort to implement those strategies proven beneficial, I think that progress in patient safety will be very slow,” he said.

To read more about the study, click here.
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