Thursday, November 25, 2010

Hospital mistakes not declining, study finds

Hospitals have not become safer for patients, the first major study in a decade suggests. A Harvard Medical School study of 10 unnamed rural and urban North Carolina hospitals from 2002 to 2007 found that, in spite of preventive efforts, the number of incidents that harmed patients did not decline over the time studied. The study looked at the Tar Heel State because its hospitals have been more involved than most in prevention.

Complications from procedures or drugs and hospital-acquired infections were the most common adverse events. The study, which is being published today by The New England Journal of Medicine, found that about 18 percent of patients were harmed by errors that were preventable 63 percent of the time. While most were treatable injuries, an estimated 2.4 percent contributed to or caused death."

Lead author Dr. Christopher P. Landrigan, a Harvard professor, said it is unlikely that hospitals in other regions are performing any better. He said the present limited voluntary reporting system is insufficient and a federal-level, mandatory reporting system that requires all hospitals to report errors is needed.

Dr. Robert Watcher, chief of hospital medicine at the University of California, San Francisco, told Denise Grady ofThe New York Times that the findings are a warning for the patient-safety movement that little progress is being made far too slowly. "Process changes, like a new computer system or the use of a checklist, may help a bit,” he said, “but if they are not embedded in a system in which the providers are engaged in safety efforts, educated about how to identify safety hazards and fix them, and have a culture of strong communication and teamwork, progress may be painfully slow.” (Read more)

A recent report from the inspector general of the Department of Health and Human Services reached similar conclusions. The study of a sample of Medicare patient discharge records found that 13.5 percent or 134,000 patients had experienced injury during hospital stays in October 2008. Such injuries could cost Medicare billions of dollars a year for added treatment. In the case of 15,000 patients in the month studied, medical errors contributed to patient deaths.

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