A Johns Hopkins study claimed more than 250,000 people in the U.S. die every year from medical errors. Other reports claim the numbers to be as high as 440,000. Medical errors are the third-leading cause of death after heart disease and cancer. The reason for the discrepancy is that physicians, funeral directors, coroners and medical examiners rarely note on death certificates the human errors and system failures involved. Yet death certificates are what the Centers for Disease Control and Prevention rely on to post statistics for deaths nationwide. Dr. Martin Makary of the Johns Hopkins University School of Medicine led the study.
Critics of this analysis have pointed out many flaws. It is based on studies whose data was never meant to be generalized to the entire U.S. hospitalized population. They argued Using studies that identify medical errors that were followed by death to declare that these medical errors necessarily caused these deaths is not fair.
Medication errors like dispensing wrong medicines and treatment are taking five lives every minute, says the World Health Organisation (WHO) on patient safety day. Apart from loss of life, the cost of inefficient healthcare is pegged at $40 billion annually.
Unsafe healthcare results in the death of 2.6 million deaths annually, in low and middle income countries. Further, four out of ten people suffer for the lack of primary care or an ambulance and other avoidable instances
“Unsafe surgical care procedures cause complications in up to 25% of patients resulting in one million deaths during or immediately after surgery annually,” said WHO.
Medical error causes
However, still it is necessary to know the causes of medical errors and how they can be prevented.
Errors can occur at either the individual- or systems level and play a complex role. Errors in medicine include wrong diagnoses, drug dosage miscalculations, and treatment delays. Errors can involve medicines, surgery, diagnosis, equipment, or lab reports. Although many errors may be without consequence, medical errors can cause patient harm and lead to or accelerate death.
Makary defines a death due to medical error as one that is caused by inadequately skilled staff, error in judgment or care, a system defect or a preventable adverse effect. This includes computer breakdowns, mix-ups with the doses or types of medications administered to patients and surgical complications that go undiagnosed.
Some examples of medical errors are:
- Having surgery done on the wrong area of the body.
- Getting the wrong meal while in the hospital, such as a regular meal when you need a salt-free meal.
- Getting the wrong medicine or the wrong dose of medicine.
- Getting a diagnosis or lab test that is not correct.
- Not knowing what doctor instructions mean and doing the wrong thing.
- Having a piece of medical equipment fail or not work the right way.
Medical errors can occur anywhere in the health care system: hospitals, clinics, surgery centers, doctors’ offices, nursing homes, pharmacies, and patients’ homes.
The problem needs to be treated at multiple levels.
Government accreditation requires legal structures to be in place to ensure quality and patient safety. For example, regulations require hospitals to appoint a quality committee of the board. Regulations also require that every hospital has a process to appoint doctors to a hospital medical staff based on documented credentials from training programs and other regulatory bodies. The medical staff appoints a committee of doctors (usually the medical executive committee or professional affairs committee) to oversee the quality of care delivered by the members of the medical staff. These regulations must be strictly enforced.
Safety is dependent on the organization’s culture — the sum of the behaviors of leaders and staff. The top management of the hospital or health system must make safety an imperative, and should support the daily improvement of safety practices that build changes into operations and reinforce a safety culture.
John S. Toussaint in Harvard Business Review has proposed creating the National Patient Safety Board (NPSB) along the lines of the National Transportation Safety Board (NTSB). The team would consist of highly trained experts in health care safety practices. The NPSB would not be a regulator; it would function as a facilitator for changing of safety practices in hospitals. Its standards for specific practices and improvement processes would take into account the nature of the services, demographics, social determinants of health, and other factors.
The research also supports psychologists’ previous findings that medical errors often have psychological components to them—problems related to teamwork, communication, technology design, leadership and human decision-making—and that psychologists can help develop systems to prevent them. “Psychologist researchers, consultants and practitioners have an opportunity to make real contributions to this arena—describing the gaps that result in errors and how to create processes and communication that provide checks against inevitable human error,” McDaniel says.
“Patient care is a team sport,” says Eduardo Salas, PhD, who studies medical teamwork at Rice University. “It’s not just your physician or your surgeon who makes a difference in the quality of a patient’s care—it’s providers, staff and administrators working together at all levels of the health-care system who foster the right patient outcomes.”
The best thing you can do to prevent medical errors is to be involved in your health care. Learn and know about your health problem, medicine, and treatment as best you can and take part in making all decisions about your care. Talk to everyone who is involved in your health care. This includes your doctors, other health professionals, family, and friends.
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