Preventable hospital negligence and medical malpractice cause far too many patient deaths each year. A recent editorial in USA Today put this in perspective. Here are excerpts:
If a 747 jetliner crashed every day, killing all 500 people aboard, there would be a national uproar over aviation safety and an all-out mobilization to fix the problem. In the nation’s hospitals, though, about the same number of people die on average every day from medical “adverse events,” many of them preventable errors such as infections or incorrect medications. Where’s the outrage?
Obviously, patients who die one-by-one don’t attract attention the way a fiery air crash does, and the problem isn’t new. A 1999 report by the Institute of Medicine estimated that as many as 98,000 people a year died in hospitals from medical errors. Now, 11 years later, a new survey from the inspector general of the Department of Health and Human Services finds that about 1 in every 7 Medicare patients in hospitals suffers a serious medical mishap.
The report says these adverse events contribute to the deaths of an estimated 180,000 patients a year. Of those, roughly 80,000 are caused by errors that could be caught and prevented, such as letting infections develop, giving the patient the wrong medication or administering an excess dose of the right drug. Aside from the human toll, the extra medical care required to correct for these mistakes costs taxpayers more than $4 billion a year.
It’s a problem crying out for a fix, and here are three remedies already being used but worth expanding:
- Checklists. No airline pilot would dream of taking off without using a checklist, and increasingly, medical personnel are being encouraged to use them, too. Studies show that forcing surgeons and nurses to follow simple steps they sometimes skip —donning sterile gowns before inserting a “central line,” for example — can dramatically lower infection rates and save lives.
- Transparency. Until recently there was little beyond word of mouth to help people decide which hospital they wanted to go to. Now, the government runs an increasingly robust Hospital Compare website to allow patients to evaluate their local hospitals. (USA TODAY.com and HealthGrades.com also carry comparisons.) There’s nothing like pressure from consumers and competitors to force a business to do better.
- Financial incentives. Medicare won’t pay for the extra care required to treat patients whose conditions worsen as a result of hospital-acquired conditions that are “reasonably preventable,” such as giving a patient a transfusion of the wrong blood type. And the new health law penalizes hospitals with the worst error rates. In both cases, the principle is the same: Hospitals shouldn’t profit from failure.
These and other remedies — increased use of electronic prescriptions and medical records, for example — should help chip away at health care’s stubbornly high error rate.
It has taken decades of aggressive effort to reduce aviation accidents. While medicine is far more complex, the same sort of single-mindedness is needed to decrease the unacceptable level of medical “crashes.”
