Researchers on patient safety at the Johns Hopkins University School of Medicine released a report a few months ago citing that medical errors in hospitals and other healthcare facilities are incredibly common and may now be the third leading cause of death in the United States. They define medical errors as “an unintended act (either of omission or commission) or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient.”
According to the research, medical errors – from surgical complications that go unrecognized to mix-ups with the doses or types of medications patients receive – claim 251,000 lives every year. This is more than respiratory disease, accidents, stroke and Alzheimer’s.
John Hopkins Professor Martin Makary, who lead the research, performed a comprehensive analysis of four large studies, including those conducted by the Health and Human Services Department's Office of the Inspector General and the Agency for Healthcare Research and Quality that took place between 2000 and 2008. Then, using hospital admission rates from 2013, he and his colleagues extrapolated that based on a total of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error, which equates to nearly 700 deaths a day – or about 9.5% of all deaths annually in the United States.
The researchers, however, caution that most medical errors aren’t due to inherently bad doctors, and that reporting these errors shouldn’t be addressed by punishment or legal action. Rather, they say, most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.
Among the issues pointed out in the research is the healthcare community’s shortcoming in tracking vital statistics that may hinder research and keep the problem out of the public eye. Moreover, the coding system used by Centers for Disease Control and Prevention (CDC) to record death certificate data doesn’t capture things like communication breakdowns, diagnostic errors and poor judgment that cost lives, the study said. This makes it difficult to see what is happening nationally.
In addition, tremendous diversity and complexity exists in the way healthcare is delivered. To demonstrate this, one physician compared the healthcare industry to the airline sector. “When passengers get on a plane, there’s a standard way attendants move around, talk to them and prepare them for flight,” the physician stated, “yet such standardization isn't seen at hospitals. That makes it tricky to figure out where errors are occurring and how to fix them.”
Professor Makary also used an airplane analogy in describing how he thinks hospitals should approach errors, referencing what the Federal Aviation Administration does in its accident investigations: “Measuring the problem is the absolute first step,” he said. "Hospitals are currently investigating deaths where medical error could have been a cause, but they are under-resourced. What we need to do is study patterns nationally.” He said that in the aviation community every pilot in the world learns from investigations and that the results are disseminated widely.
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Sources: Washington Post, NPR, John Hopkins