By Dave Warner
When it comes to medical errors, experts can agree on at least one thing: they happen.
Indeed, one of the landmark studies on the issue, from the prestigious Institute of Medicine, is called, “To err is human.”
“…many have witnessed situations in which their family member was seriously injured or died due to a medical error,” said Dr. Carolyn Clancy, head of the federal government’s Agency for Healthcare Research and Quality.
Not even the famous are immune to such error, she pointed out, citing the case of actor Dennis Quaid, whose twin infant son and daughter, were given a dangerous high dose of blood thinner in 2007. Quaid has since become an advocate for patient safety. The children survived.
So how many Americans die from medical errors each year?
That is the subject of much debate.
Many cite a figure from the Institute of Medicine, an arm of the National Academy of Sciences, from 1999 that estimates 44,000 to 98,000 patients die each year in hospitals because of medical error.
But in 2011, a new study using data from three large hospitals spiked interest in the subject. This one, which dealt not just with death but also with “adverse events,” was published in the journal Health Affairs, and concluded:
“We found that the adverse event detection methods commonly used to track patient safety in the United States today – voluntary reporting and the Agency for Healthcare Research and Quality Patient Safety Indicators – fared very poorly compared to other methods and missed 90 percent of the adverse events.”
Instead, the study used what is called a global trigger tool from the Institute for Healthcare Improvement. Basically, the tool used in the study uses trained medical personnel to go over patient charts to look for so-called “triggers” to look for abnormalities in such things as discharge codes, a medication stop order, an abnormal lab result or the use of an antidote medication.
The result: the tool found at least 10 times more confirmed, serious events than these other methods.
“Overall, adverse effects occurred in one-third of hospital admissions,” said the study, which was conducted by 10 medical professionals including Dr. David Classen associate professor of medicine at the University of Utah.
The study also said that merely counting the number of deaths from medical errors? is a crude measurement that does not deal with overall patient safety issues.
A total of 795 patient records were reviewed from the three unidentified hospitals in the study. The findings:
- Of the 795 records that were reviewed, 393 showed adverse effects, most detected by the Global Trigger Tool.
- That works out to just over 33 percent of the patients with such effects.
- Patients who were impacted tended to be older than the averages, and were in the hospital longer.
Clancy notes that many patient safety advocates have witnessed their family members be either injured or killed my medical error.
“Some hospitals are reducing the risk of medical errors by forming patient safety advisory panels,” Clancy writes on the agency’s Web site. “These councils serve as a bridge between hospitals and patients to increase communication between patients and health care professionals.”
Medical error issues are on the minds of many, as evidenced by Clancy’s statement that her agency is out to change things.
A survey by the highly regarded Kaiser Family Foundation, which specializes in health issues, showed that five years after the landmark Institute of Medicine findings in 1999, Americans did not think medical quality had improved. Nearly 40 percent of the people in a survey released in 2004 said the quality of their care had worsened since the institute report. Nearly half said they were concerned about the quality of their medical care.
Beyond the cost to the health of patients, another study reported the financial cost of all this -- $17.1 billion in 2008, according to a study in the Health Affairs journal.
What can a patient do?
Plenty, says the federal agency that Clancy heads, the Agency for Healthcare Research and Quality. Here are some of the agency suggestions:
- Tell your doctor about every medication you take, even the over-the-counter ones as well as vitamins and herbs. You can even bring them to appointments if that makes it clearer.
- Have you had bad reactions to a medication in the past? Tell your doctor.
- Do you think your pharmacist can read your doctor’s handwriting on a prescription? Make sure. Also, ask the pharmacy if what you’re getting is exactly what your doctor prescribed.
- Ask specific questions about prescriptions – how long are you supposed to take it, what are the side effects; is there any interaction with other medications?
- If you’re a patient in a hospital, make sure everybody who cares for you washes their hands first.
- Ask your doctor about your treatment plan at home once you’re discharged.
- Before surgery, make sure you and the surgeon agree on exactly what will be done – and where. If it’s your right knee, make sure the doctor knows that, for instance.
- If possible, choose a hospital with experience in the procedure you’re having.
- Ask questions.
- Make sure your primary care doctor, or someone else, is coordinating all of your care.
- Learn about your treatment options.
- Take a friend of family member to appointments with you.
- Ask why a test or treatment is needed.
- Make sure all of your doctors have you health information.
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