How to Prevent Medical Errors: Part I
According to the CIA factbook 49 countries have greater life-expectancies than the U.S. The U.S. average life-expectancy is 76.5 years. In Monaco, the average life-expectancy is 89 years. Australia, which has a Medicare for all system, has an average life-expectancy of 82 years—more than five years greater than the U.S. Canada has a similar average life-expectancy of 81.5 years. However, for some states such as Mississippi, the life-expectancy is more similar to a war zone. According to these estimates, Mississippi would rank 144th if it was on the country ranking list—next to war torn Iraq. In the U.S., if you’re poor, you can expect to live five years less than a wealthy person.
In 2000, The Journal of the American Medical Association reported that the third leading cause of death in the U.S. was medical errors. As the Impartial Review recently noted preventable medical mistakes may now be the leading cause of preventable death in the United States.
A number studies have shown how medical errors can be prevented. Hospital acquired infections and medication errors are the two most common types of medical errors. The good news is that programs have shown ways to greatly reduce the mortality rate. For example, six hospitals in the Portland, Oregon used best practices to prevent four common health care-associated infections. Next; they reviewed deaths and revised procedures based on the findings; and included staff from different disciplines in daily medical rounds. The result was a 44.6 percent reduction in infections and a 13.5 percent reduction in mortality, as well as annual savings of more than $6.8 million for each of the first two years from the avoided costs of treating hospital acquired infections.
There is evidence that many other solutions also work as well. For example, research suggests that regulatory bodies should refocus their oversight to consider an institution’s overall structured approach to quality improvement and safety instead of monitoring individuals randomly and looking for variation from standards. Others have suggested that even greater results can be achieved by adopting the safety principles used in high-reliability industries such as the nuclear power industry. Another possibility is the use of automated control systems. More clinical pharmacists in hospitals have been shown to reduce medical errors. Similarly, patient mortality has been linked to nurses’ educational attainment. Therefore, more education and training of nurses may reduce medication errors. For many of the most common types of medical errors (e.g., medication errors, healthcare-acquired infections, falls, handoff errors, diagnostic errors, and surgical errors), effective methods for reducing harm have been developed. Another possibility includes better coordination of care. A more centralized system as found in most other countries would also improve care as state and local governments often do a poor job of correcting known problems. Poor job satisfaction among health care workers is higher in the United States than many other countries and some believe that job stress and dissatisfaction can contribute to medical errors. Others believe that U.S. health care workers are overworked.
The Health Care Reform law attempts to reduce medical errors in a number of ways including the use of health information technology. For example, computerized medical records provide warnings and checks for medical errors.. A recent review found that 92 percent of the recent articles on health information technology suggested that it works. There is also evidence that improvements in the health technology could lead to even greater reductions in medical errors. The President as part of the health care reform bill also created a Partnership for Patients program to encourage the reduction of medical errors. Similar plans have been effective in other countries but they were associated with government regulation. The Partnership for Patients program is not.
It’s expected that the U.S. will now maintain its position or improve relative to other countries. For decades, the U.S. life-expectancy ranked about 20th before is began to loose ground when it did not move to a public healthcare system as other countries did. However, preventing medical errors is not the only way to improve the quality and length of life of Americans. For example, other countries have or are planning to pass laws that regulate the quality of food, smoking and other public health quality measures that may keep them ahead of the U.S. The video above illustrates that lack of exercise and poor diets are a big part of the problem as well.
However, the U.S. could move ahead of other countries by actually implementing the changes described above. The consistent problem is that government regulators have consistently weakened oversight and lawmakers have failed to enact programs that are needed for their implementation. In part II of this series, we will discuss more about why politicians from both parties refuse to act and why the media refuses to report on the problem.
by Todd Miller
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