Medical errors - Is healthcare getting worse or better?

May 28 2008

Most would say worse. And one of the many reasons is medical errors. Most Americans say the quality of care has not improved, and dissatisfaction among patients and caregivers has increased. The perceptions exist despite the efforts across the country to reduce medical errors.

The result of medical errors includes death, long-term disability, and pain. The causes of medical errors include, but are not limited to: poor communication among caregivers, inadequate staffing, stress, fatigue, and the nursing shortage, doctors not spending enough time with patients, order transcription errors, and adverse drug events.  Health care providers want to delivery safe, high-quality health care to patients. Despite this, preventable errors occur causing harm to patients.

The Agency for Healthcare Research and Quality (AHRQ) and Joint Commission (JC) are two agencies that promote creating a culture of patient safety. This includes reporting events that have the potential to threaten the safety of patients while viewing these events as opportunities to better the health care system. Some of the safe practices endorsed by these organizations include:

• Matching health care needs with service delivery quality - for instance, for high-risk, elective surgical procedures, informing the patient of the risks of any adverse outcomes and referring the patient to facilities who have demonstrated superior outcomes. Ensure adequate levels of nursing based on the institution's patient mix, and the experience and training of the nursing staff.
• Facilitating clear communication - recording verbal orders and reading them back to the prescriber for verification. Use standardized abbreviations. Timely transmission of care information. Prominent display of living will preferences and/or do not resuscitate (DNR) orders on the chart. The agencies recommend implementing a computerized prescriber-order entry system and standardized protocols for wrong-patient, wrong-site surgical procedures.
• Increase safe medication use - standardize methods for labeling, packaging, and storing medications. Identification of high alert drugs, for example, anti-coagulants and thrombolytics.

Along with physicians, health care providers, and government agencies working together to make our health care system safer, providers should encourage patients to take responsibility to protect themselves. The best way to do that is for the patient to take an active role by becoming involved in all decisions regarding their health care. This includes keeping the health care team informed, asking for information and becoming informed on all treatments and procedures recommended.

In October, 2008, Medicare will no longer pay the costs of treating patients who develop serious, preventable conditions while they are hospitalized. These include pressure ulcers, falls from the bed, and catheter-associated urinary tract infections. Many insurers are heading toward following in Medicare's footsteps. Many hospitals are moving toward not billing patients and/or insurers for preventable errors that have occurred. However, some believe that waiving fees, along with apologizing, amounts to admitting liability, which could attract more lawsuits.

The bottom line is that though there is no all-encompassing solution to prevention of medical errors, health care providers are collaborating to improve patient safety and becoming accountable.

Resources

Agency for Healthcare Research and Quality - Fact Sheet. AHRQ Pub No. 05-P007, March, 2005.

Joint Commission - National Patient Safety Goals.

This article is republished with kind permission from our friends at the American Society of Registered Nurses. Get ASRN journals delivered to you via email. Copyright 2008 - American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved.