5 Scary Things About Healthcare Quality

Cheryl Clark, October 31, 2013

Despite stringent hospital protocols and watchful government agencies, preventable medical errors continue to severely harm or cause death to some 400,000 patients a year in this country.

Sometimes stories about medical harm are especially creepy and bizarre, especially when incidents that should by now have been made impossible happen anyway.

It gives me nightmares to think that despite the most diligent precautions by providers, wrong site surgeries, retained foreign objects and other tragic medical errors cause avoidable death to some 400,000 patients a year in this country. Still.

Today is Halloween, a time when we honor the dead. In Mexico, as in some parts of the U.S., November 2 is called Día de Muertos. In healthcare, it may also be a time when we think about those patients who, but for some unfortunate confluence of regrettable snafus, would still be alive.

Here are a few recent news items that I find particularly unsettling.

1. Medical Errors Account for 440,000 Deaths a Year

First on my list is a most fearsome paper by John T. James in the September issue of the Journal of Patient Safety. James, a pathologist with Patient Safety America in Houston, analyzed multiple studies to draw this eye-opening conclusion:

Providers are greatly under-reporting patient deaths that result from their medical errors. He says that at least 210,000 deaths a year in the U.S.—and as many as 440,000—can be blamed on provider mistakes, mostly occurring in hospitals. That's more than four times the amount estimated by the Institute of Medicine's 1999 report, To Err Is Human.

James counted errors not just of commission, such as the administration of an incorrect drug or dosage, but of omission, communication, diagnosis, and context (such as when physicians fail to consider a patient's limited cognitive abilities to comply with medical treatment).

He also counted not just those in-hospital deaths resulting from those errors, but deaths that occurred months after patients left the hospital.

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