The numbers are staggering.
There are more than 100,000 dead. Costs measured in tens of billions of dollars.
I'm not talking about the tsunami.
These numbers describe the yearly toll of medical errors.
Up to 70 percent of medical errors can be prevented. What is being done to assure your employees get safe medical care, and minimize your business costs associated with preventable medical errors?
A medical error is the failure to complete an intervention as intended or the use of the wrong plan. Sometimes medical errors result in no harm. Other times they lead to an adverse event, or an injury caused by medical management rather than the underlying disease or condition of the patient.
Common errors include medication mistakes, infections, operations on the wrong surgical site, errors in diagnoses and equipment failure like defibrillators with dead batteries.
Medical errors were skeletons hidden in the closet whose doors opened five years ago when the Institute of Medicine (IOM) released the report To Err is Human.
It offered an eye-opening statistic: up to 98,000 hospitalized Americans die each year from preventable medical errors, making medical errors the eighth leading cause of death in the United States, ahead of breast cancer, AIDS or car accidents.
Estimates of the costs to the business community vary from $17 billion to $29 billion, including direct medical costs and indirect costs, such as absenteeism and presenteeism. Even your healthy employees are less productive or absent when managing the consequences of a relative's medical errors. While there is debate about the numbers, there is consensus that preventable medical errors represent a significant problem.
This IOM report emphasized that medical errors are a result of systems problems rather than the negligence of doctors or nurses.
Systems improvements reduce the error rates and improve the quality of health care even when doctors with the best intentions make mistakes.
Every participant in the heath-care system has offered ideas to make patient care safer. The government has created federal agencies and passed legislation to protect the public. The medical community is creating safety nets that will protect patients, like limiting doctors' working hours. Members of a health-care team put through the aerospace industry's crew resource management training believe that participation in the program will reduce errors and enhance patient safety.
The Leapfrog Group, a consortium of Fortune 500 companies leverages their health-care purchasing power to trigger hospital changes that are proven to increase safety.
Targeted practices include the introduction of computerized physician order entry systems, staffing the ICU with doctors who have special training in critical care, implementation of the National Quality Forum's 27 safe practices and evidence-based hospital referrals that directs health-care consumers to hospitals with extensive experience and the best results with high-risk surgical procedures.
Five years after medical errors appeared on the public's radar screen, the problem is far from fixed.
In fact, the public's perception is that health care is less safe, most likely because errors are openly discussed. Some barriers to progress include dissension about where to focus safety improvements and how to collect and report information about quality and safety. The IOM's 2003 report clearly states that what we most need is a culture that encourages sharing rather than hiding of errors. Doctors are concerned that they will get sued if they report their errors. We witnessed a local hospital offer a full and open disclosure of a tragic error that resulted in a patient's death. It may be that tort reform and development of a cogent plan to create a safer medical system will go hand-in-hand.
Your most direct route to reduced business cost of medical errors is this: help your employees become active participants in their health care. One small employee action, like filling all prescriptions at the same pharmacy to flag potential adverse drug interactions can make the difference between quality care and care that harms rather than helps ... and costs more. Even if you are not a Leapfrog participant, you have access to quality data that can help your employees decide where to get medical care.
Just as every dollar collected for tsunami victims adds up, so, too each small safety step counts. Safety resides in the details, so vigilance is required. Each effort to prevent medical errors, including policy changes and an innovative systems design improves patient safety. Ultimately it may be your employees' efforts, under your leadership, that tip the scales in the direction of safety.
Here are seven steps to encourage safety that you can recommend to your employees.
- Keep copies of your medical records. Bring a self-addressed stamped envelop to your doctor appointment and ask your doctor to mail results to you.
- Ask your doctor or nurse to wash before touching you, if they forget.
- Carry a complete list of medications with you, including medication name and dose. Know why you're taking each medication and be sure to include herbal remedies, vitamins and over-the-counter drugs.
- If you're hospitalized, introduce yourself to each staff member and make sure the offered medication is intended for you and the study you're about to undergo is ordered for you.
- Be sure you understand what your diagnosis is and how it was made.
- If you think your medical care is going off course, speak up. Tell your doctor why you're concerned. If your doctor dismisses your concerns, find another doctor.
