Medical Errors Back to top
Even though patient safety is a priority for health care providers, medical mistakes do happen. These mistakes may involve medicines, surgery, diagnoses, equipment failures or inaccurate test results among others. They can occur anywhere in hospitals, clinics, surgery centers, doctors’ offices, nursing homes, pharmacies, and even patients’ homes. This unsafe care kills tens of thousands of Americans each year. (Agency for Healthcare Research and Quality)
- 10% of Medicare patients die due to safety failures
- Medication errors harm about 1.5 million Americans
- Preventable medical mistakes in hospitals are the third leading cause of death, surpassing the number deaths caused by car accidents, breast cancer, and HIV/AIDS
- Research indicates that over 200,000 Americans die from preventable hospital errors annually
- When researchers include the diagnostic errors, errors of omission and failure to follow medical guidelines, this number is 440,000 preventable hospital deaths
- Diagnostic errors may account for 40,000-80,000 deaths
- Health care associated infections kill more people than prostate and breast cancer combined.
- These are infections patients’ acquire while being treated for non-related medical care
- The most common are catheter-related bloodstream infections, surgical site infections, and hospital-acquired pneumonia.
All of these types of patient safety events result in $8.9 billion in excess health care costs annually. (Health Care Intelligence Network 11/14/14) “American health care faces a crisis in quality. There is a dangerous divide between the potential for the high level of quality care that our health system promises and the uneven quality that it actually delivers”. (Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation)
Diagnostic ErrorsBack to top
Many diagnostic errors are minor, but some can lead to serious problems or even preventable deaths. A recent review of 25 years of medical malpractice claims indicates that about 80,000 to 160,000 patients suffer permanent disabilities due to diagnostic mistakes each year. “We have to make this more transparent than it has been and we need public reporting, we need required metrics, we need regulatory requirements and we need policy,” (Dr. Newman-Toker, associate professor of Neurology at the Johns Hopkins University School of Medicine, April 24, 2013 Time magazine article)
There are several reasons that consumers face challenges during the diagnostic path.
- They fear being seen as difficult if they complain.
- They feel powerless.
- They don’t take their health problems seriously.
- They’re unsure about the basic operation of the health care system.
- They have difficulty in dealing with doctors.
- They don’t know who is in charge and available to discuss unresolved issues.
- They feel that sometimes health care professionals.
- dismiss patients’ complaints and knowledge.
- do not listen to concerns about symptoms.
- give psychiatric, alcoholic or drug abuse diagnoses incorrectly.
(Synthesis of comments generated at the 2014 Diagnostic Errors in Medicine Conference. BMJ Qual Saf 2013;22:ii33-ii39)
Roadmap to QualityBack to top
The National Quality Strategy, required by the Affordable Care Act of 2012, creates national goals and priorities to guide local, state, and national efforts to improve health care quality. The strategy has three objectives:
- Improve overall quality by making health care more patient-centered, reliable, accessible, and safe.
- Improve the health of consumers by supporting proven interventions to address behavioral, social, and environmental causes of medical issues, in addition to delivering higher-quality care.
- Reduce the cost of quality care for individuals, families, employers, and government.
Also, the Gordon and Betty Moore Foundation recently released A Roadmap for Patient + Family Engagement in Health Care Practice and Research. This roadmap presents a vision for moving towards a health care system that truly places patients and families at the center of every decision. The vision promotes usable information regarding the risks, benefits, costs, and lifestyle implications of different treatment options. (www.patientfamilyengagement.org)
The good news is that recently The Agency for Health Care Research and Quality established that approximately 1.3 million fewer patients were harmed in hospitals between 2010 and 2013. That represents a cumulative 17% reduction, preventing about 50,000 deaths and a three-year cost savings of almost $12 billion.
YOU ARE PART OF THE SOLUTIONBack to top
You can help prevent errors by being an active member of your health care team involved in every decision. Research shows that if you do this, you tend to get better results. The Joint Commission and the Agency for Health Care Research and Quality provide the following suggestions.
Speak Up If You Have QuestionsBack to top
Do not worry about being embarrassed if you do not understand something. Ask again and again until you do understand. You have the right to ask questions of everyone involved with your care. To help get the right diagnosis, you may want to ask:
- What could be causing my problem?
- What else could it be?
- How and when will I get any test results and what should I do to follow up?
- All patients have the right to see and review all test results.
Participate In All Decisions Regarding Your Health CareBack to top
You should be the center of the health care team, and you need to educate yourself about your illness, the medical tests you will get and possible treatment plan. You can do so by talking with a doctor, looking at reliable sources on the Internet or visiting a local library.
If you are unsure about the best treatment, ask for a second opinion. The more you know about treatment options based on the latest scientific evidence (http://www.effectivehealthcare.ahrq.gov/index.cfm/research-summaries-for-consumers-clinicians-and-policymakers/), the better you will feel about the decisions you make. Make sure that your primary care doctor coordinates all of your health care.
Know What Medicines You Take and WhyBack to top
Medication errors are the most common medical mistakes (www.drug-injury.com). Therefore, consumers should ensure that all doctors know every medicine you are taking, including prescriptions and over-the-counter medicines, supplements, vitamins, and herbs. Every health care professional should know about medication allergies or adverse reactions. This can help avoid getting a medicine that could harm you. It is a good practice to carry a list of your medications and dosages with you at all times.
If you get a new prescription, make sure that you can read it since the pharmacist might not be able to read it either. Ask the doctor about new medications:
- What is the medicine and why is it needed?
- How should it be taken and for how long?
- What is the required dose and what time of day should it be taken?
- What side effects are likely and what to do if they occur?
- If you take several medications, ask if it is safe to take the new medicine. .
- Do the same thing with vitamins, herbs, and over-the-counter drugs.
- What, if any, food, drink, or activities should be avoided while taking the medicine?
- Ask your pharmacist if you have any questions about the directions on the medicine label and the best device to measure any liquid medicine.
- Household teaspoons and tablespoons are not good for measuring liquid medications.
Only Use Accredited Health Care Service ProvidersBack to top
The Joint Commission visits hospitals and other providers to ensure they are meeting the Commission’s quality standards. These inspection reports are available (www.qualitycheck.org) to review and to determine if the facility is accredited. Accreditation means that the provider follows the quality standards to ensure patient safety. There are specific tools regarding hospital quality comparisons from Medicare’s Hospital Compare (www.medicare.gov/hospitalcompare) and the Leapfrog Group’s Hospital Safety Scores. (www.leapfroggroup.org).
Regardless of the type of provider, be sure that you get the correct treatment from the correct health care professional. All health care professionals should review your medical records – do not assume that they all have the information they need. When being discharged from the hospital, ask about the home treatment plan. Having clear instructions may help prevent a return trip to the hospital.
Surgery ConsiderationsBack to top
Choose a hospital with extensive experience with the surgery you need. Patients tend to have better results when they use hospitals that have a great deal of experience with their condition or surgery (www.frenkelbenefits.com/sc_consumer/article04.html). Some hospitals are better for certain surgeries. Make sure that you, your primary care doctor, and the surgeon all agree on exactly what will be done during the surgery. Ask the surgeon:
- Exactly what will you do?
- About how long will it take?
- What are the risks?
- How will I feel during recovery?
- What will happen after the surgery?
Wrong-site surgery (operating on the left knee instead of the right) does occur and is 100% preventable. Ask the surgeon to write her name directly on the location that will be operated on before the surgery.
Use an Advocate When Receiving Hospital CareBack to top
You may not be at your best when you are sick and your judgment may be impaired, especially after surgery. An advocate can ensure that you are getting the correct medications, treatments, and pain management. Use a family member or friend to be your advocate to ask questions that you may not remember and to write down important information being discussed. An advocate can also help you navigate the confusing health care system. Select someone who is assertive, with good communication skills and who will assure that your wishes are met if things go wrong.
Advice for Getting the Correct DiagnosisBack to top
The diagnosis you receive may be the most common for your symptoms, but it may not be the correct one. Don’t be afraid to ask if it could be something else. Tell the doctor when symptoms started, what makes symptoms better or worse, or if symptoms are related to taking medications, eating a meal, or exercising. Often you will first see a nurse or technician who may ask you questions about your illness before you see a doctor. Make sure that the doctor hears the same story.
Discuss your family’s medical history because you may be at risk for similar illnesses. Keep records of test results, referrals, hospital admissions, and medications. Ask what to expect from any treatment and what you need to do if you develop new symptoms, or start to feel worse.
The contents of this site include educational information only and are not meant to be a substitute for professional medical advice. Never ignore professional medical advice or delay getting the advice because of something you have read on this site. Always seek the guidance of your physician or another qualified health provider with any questions regarding your personal health or medical conditions. Reliance on any information provided on this site is solely at your risk. Call your doctor or 911 immediately if you think you may have a medical emergency.