The Hospital Harm Factor
The very first principle of the Hippocratic Oath, which all doctors swear to, is: "First do no harm." We need to insist that our health care system adheres to that principle. The way things stand right now, it's downright scary the number of patients who are harmed -- sometimes even killed -- as a result of problems with the care in hospitals today.
Yet one more study, this time focused on those who receive their health care through Medicare, recently found that one out of every seven people admitted to the hospital is hurt in one way or another by the medical staff. The research was conducted by the Office of the Inspector General for the Department of Health and Human Services and looked at patient records from hospitals across the country.
These so-called "adverse events" were estimated to contribute to the deaths of approximately 180,000 people each year in the United States. If true, that would make hospitals the third leading cause of death, after heart disease and cancer.
Aside from dying, the lesser problems routinely experienced by hospital patients included infections, reactions to medications, poor patient care such as issues with intravenous fluids, and post-surgical mishaps. As if all of those possibilities aren't scary enough to the poor souls who have to be hospitalized, the report said nearly half of these instances should never have taken place. The researchers classified 44% of the problems as "clearly or likely preventable."
In this study, which focused on hospital care in the month of October 2008, it was estimated that 134,000 Medicare patients experienced some sort of setback in the hospital setting. Overall, the researchers projected that these occurrences are costing the U.S. government more than $4.4 billion each year.
The research and ensuing report were intended as a follow-up of sorts to see how the healthcare industry is doing in the patient safety arena a decade or so after a 1999 report by the Institute of Medicine called "To Err is Human: Building a Safer Health System." That report relied on several studies to determine that between 44,000 and 98,000 Americans died each year due to preventable medical errors taking place in hospitals. With the latest numbers showing a 200-400 percent higher rate of death from medical error, it seems we're making outstanding progress…in the wrong direction. Amazingly, studies have shown that if hospitals just instituted simple checklist procedures, many of these problems would disappear. But it isn't happening.
Part of the problem lies in the fact that there are no national standards for hospital care and the medical harm that happens all too frequently. Each state has its own policies in place, and they vary widely. Only a little more than half the states even bother to track these medical mistakes and the resulting adverse events taking place in their hospitals. (Makes you wonder what the numbers really are.)
Numerous other studies in the past few years have shown similar results, unfortunately. In a recent examination of 10 North Carolina hospitals by researchers at Brigham and Women's Hospital in Boston, the medical harm taking place was found to be common and more than 60% of the injuries were preventable. The most often-cited incidents involved medication errors, surgical complications, and infections acquired during the hospital stay. In this study, 18% of patients were harmed by the medical "care" they received, and some were harmed in more than one way.
These problems are nothing new. We've posted about medical harm in hospitals plenty of times here. Pharmaceutical drugs, even when administered correctly, cause a staggering number of deaths and serious adverse drug reactions within hospitals each year. And those numbers, all too high at any time of year, spike in the month of July. A study from the University of California at San Diego found that July is the deadliest month for medication mistakes by 10% every year. The researchers reviewed 62 million death certificates issued between 1979 and 2006. Nearly a quarter of a million of them listed medication errors in hospitals as the cause of death.
The bottom line is, any time you must be admitted to a hospital, you need to advocate for yourself, asking questions and making sure everything the medical staff is doing is correct. Or if possible, have someone you trust advocate for you. And also, if possible, try to pick a hospital that uses checklists. This is one situation you cannot leave to chance…ever.