Hospital errors affect 1:3 patients

How common are hospital errors?

A shocking new study suggests that the number of “adverse events” befalling patients in U.S. hospitals may be 10 times higher than previous estimates.

If the authors are correct, this would mean that medical mistakes affect one in three people hospitalized  in the US. The study, published in the journal Health Affairs involved a review of almost 800 patient charts at three U.S. hospitals. Using a review technique known as the “global trigger tool,”  researchers detected a whopping 354 adverse events. Scarier still,  that figure might actually understate the enormity of the problem as it was based on potentially incomplete medical records rather than on direct observation in real time.

Dr. David C. Classen of the University of Utah believes his study gives a more reliable tally of hospital errors than other studies, including a 1999 landmark study from the Institute of Medicine entitled To Err is Human showing that hospital errors caused up to 98,000 Americans each year.

So what sorts of events were uncovered in the new review? According to Classen, there were three big ones:

The question many are now asking: is the new estimate accurate?

It is hard to know that to make of the trigger tool,” admits Dr. Peter J. Pronovost, a Professor in the Johns Hopkins University School of Medicine (Departments of Anesthesiology and Critical Care Medicine, and Surgery) and Medical Director for the Center for Innovation in Quality Patient Care.

However, “Far too many patients suffer preventable harm in the U.S.” he added.

Other recent studies appear to confirm Classen’s findings.

Earlier this month the US government released data for the first time, showing how often patients are injured by certain medical errors in hospitals.  However, only eight types of serious, preventable errors were included in the comparison.

They were: air in the bloodstream, falls, bedsores, transfusions with the wrong blood type, urinary tract infections, blood infections, uncontrolled blood-sugar levels and foreign objects left in the body after surgery.

Other serious events, including wrong-site surgeries and medication errors, were not included.

And late last year, the Office of Inspector General for the U.S. Department of Health and Human Services said 180,000 Medicare recipients die each year from hospital mistakes. That’s more people than are killed every year in car crashes, or from diabetes or pneumonia.

Without doubt, health care has improved over the past decade, but it’s clear that there is still a great deal of work to do in order to achieve a health care system that safe, effective, patient-centered, efficient, timely, and devoid of disparities based on race or ethnicity.

Until then, SRxA’s Word on Health advises that if you think something is amiss or wrong with your hospital care, speak up.

Kiss and Tell?

About 300 years ago, the English author Alexander Pope famously wrote “To err is human, to forgive is divine.

New research from the University of Illinois, Chicago concurs.  According to a study published in the November issue of Medical Care, people who believe their doctor or hospital would inform them if a medical error occurred are far more forgiving than those who doubt their health care provider would disclose the error.

A medical error is defined as a preventable adverse effect of care, whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete  diagnosis or treatment of a disease, injury or other ailment. Medical errors are one of the nation’s leading causes of death and injury and cost the US approximately $10 billion annually.  The Institute of Medicine estimates that as many as 300,000 patients are victims of medical errors, of which maybe as many as 200,000 people die.

In the new study, researchers surveyed a representative sample of Illinois residents regarding medical errors. About 40% of participants either had personal experience with medical errors, or had a close friend or family member who had been affected by an error.

Based on a hypothetical scenario, just 10% of survey respondents believed their physicians would be “very likely” to tell them if a medical error occurred. Yet, only a quarter said they would file a medical malpractice lawsuit if they were told about a medical error.

Respondents who trusted their doctor to disclose medical errors were no more (or less) likely to say they would sue. This was so even in a scenario where the health care provider offered to correct the problem through free additional medical treatment, and possibly a financial settlement.

However, people who trusted their health care provider to inform them about the error were more forgiving. Of the respondents who were most confident that their doctor or hospital would disclose the error, more than 60 percent said they would still recommend the provider, despite the error.

In contrast, only 30% of those who were skeptical about disclosure would continue to recommend the doctor or hospital.

The researchers found that although disclosure of medical errors is strongly preferred by patients, the most common policy is to “deny and defend” when errors occur because providers fear that it will trigger lawsuits and jeopardize their reputation.

The results show that patients perceived beliefs have a significant impact on their behavior. Patients who trust their providers to disclose errors may be no less likely to sue, but appear more likely to forgive. Conversely, patients who are most skeptical about disclosure may view their health care provider with “suspicion and frustration.”

Clearly when it comes to medical screw-ups, honesty is the best policy.