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Harmful Errors Found in One-Third of Hospital Stays

A dozen years ago, avoidable medical errors contributed to the deaths of from 44,000 to 98,000 people every year in U.S. hospitals, according to the landmark report “To Err is Human” by the Institute of Medicine.

We might not be doing any better now; in fact, we might be doing worse, even in our best hospitals, according to the April 2011 issue of Health Affairs. One major study found that significant “adverse events”—medical errors that caused harm—occurred during one-third of hospital stays. The most common were medication errors, followed by surgical errors, procedure errors, and hospital-acquired infections.

David Classen of the University of Utah and colleagues at the Institute for Healthcare Improvement (IHI) reviewed 800 randomly chosen inpatient medical records, including those from three leading hospitals that had undertaken quality and safety improvement programs. They used three different techniques to detect medical errors. The IHI’s new “Global Trigger Tool” (an expert chart review) found 10 times more confirmed serious events (354) than did hospital voluntary reporting (4 events) or the commonly used Patient Safety Indicators (35 events) created by the federal Agency for Healthcare Research and Quality (AHRQ).

Medical errors cost lives, but also dollars—as much as $17 billion in 2008 alone, according to another study by Jill Van Den Bos at Milliman’s Denver Health in the April Health Affairs. And Tracy Spinks of the MD Anderson Cancer Center and colleagues wrote about the challenges in measuring cancer care quality in particular, in part because treatment involves so many different specialists and because so much cancer treatment is delivered in outpatient settings.

Take-away for patients: Many healthcare practitioners recommend that you have  friends or family help monitor your care while in the hospital— such as writing a time-log of events (medicines given; name and specialty of physicians who visited and what they said or ordered; symptoms that occur when you’re groggy during the night or after surgery). Advocates can also jot down questions or concerns that arise between provider visits, be sure that providers wash their hands when entering the room, and generally help you manage your medical care.

Sources: Health Affairs, April 2011; Institute for Health Care Improvement (IHI.org)

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