Medical mess-ups are still the norm in most hospitals, despite all the attention being drawn to risky and preventable hospital-acquired infections and other needless medical center mistakes. Hospitals in general have not been able to effectively admit or implement proven strategies to cut such unnecessary risks, according to a new study published in the New England Journal of Medicine. These medical errors aren’t just painful for the patients and families involved, but also cost the government billions every year as additional resource-depleting treatments are required to fix botched surgeries, preventable infections, and muddled medicine administering. The study highlights the fact that medical mess-ups are the norm, not the exception. Luckily, there are some simple questions you can ask to help protect yourself.
The details: Researchers analyzed data from 2002 to 2007 from 10 randomly selected hospitals in North Carolina and found that the overall instances of medical errors remained stagnant, despite health care’s growing focus on preventing preventable hospital infections, medicine mix-ups, and surgical screw-ups.
Study lead author, Christopher Landrigan, MD, MPH, assistant professor of pediatrics and medicine at Harvard Medical School and director of the Sleep and Patient Safety Program, wants patients to understand the major take-home points of the new research. “Patients should be aware that errors in hospital are common, as is harm due to medical care,” says Dr. Landrigan. “Fortunately, in most cases, these do not cause long-lasting problems.” (On the other hand, they can sometimes be fatal.)
Here are important findings from the study:
1. Researchers found no improvement.
“In the intensive study looking at the 10 random North Carolina hospitals, we found no decrease in patient harm due to medical care,” says Dr. Landrigan.
2. These are success stories in some locations.
The lack of improvement at a regional level stands in contrast to many local successes nationwide; this implies that there is a need to take those successes that have occurred and more effectively disseminate them. “Proven strategies to reduce harm and errors such as surgical checklists, the use of computerized order-entry systems, and reduction of resident-physician work hoursâ€”need to be broadly implemented,” explains Dr. Landrigan.
3. Take it to the next level.
In order to gauge which measures are worth moving forward with on a broad scale to reduce medial error risk. “For that, we need to have a reliable national system in place for tracking rates of harm over time, Dr. Landrigan says.
What it means: So why do so many doctors seem to be screwing up? Are washing your hands between treating patients and remembering to remove all surgical tools from the patients’ body before stitching them up too much to ask? Unfortunately, the issue is more complicated than that. For starters, Dr. Landrigan says there’s been a poor adoption of many of the best-proven strategies to reduce medical errors and harms. (We’ll get into those beneficial methods in a bit.) That’s often because there’s an upfront cost to implementing these measures. But beyond that, doctors are TIRED! Although the new Accreditation Council for Graduate Medical Education limits that will go into effect next July limits first-year residents’ shift to 16 consecutive hours of work, residents in their second year and beyond do not enjoy that restriction. They can work up to 28 hours in a row. “Those residents represent about 80 of all resident physicians nationwide,” explains Dr. Landrigan.
“There is excellent data that the risk of error increases substantially after 16 consecutive hours of work,” says Dr. Landrigan, who notes that doctors working 24-plus-hour shifts remains a common situation in most hospitals. “In fact, there is some data from other industries that even beyond the eight- to 12-hour mark, risk begins to increase somewhat, but the data after 16th hour is very strong.”
Here’s how to keep medical staff on their toes:
Ask about work hours.
It may seem a bit uncomfortable for some patients, but it’s worth it. If you’re in a position to schedule a surgery, find out how many hours the operating doctor typically works in a day, and try to schedule earlier in the doctor’s workday. A recent study Dr. Landrigan was involved with found that most patients would want a different doctor if they found their doctor had been working for more than 24 hours, which is a common occurrence.
Beckon the bundle.
Dr. Landrigan says hospitals who use infection-control checklists and “bundles,” a short set of interventions to optimize sterile precautions and limit risk, are much better at reducing medical errors. Computerized systems to order tests and medication and the use of barcode scanning before administering treatment can also cut down on medical error risk.
Join the med team.
Patients shouldn’t just follow doctor’s orders mindlessly. Instead, question why certain medications are prescribed, and before taking it in the hospital, ask the administering nurse the medicine name and dose, which will force them to double check, reducing the chance of a mix-up. And of course, you should always ask medical staff to wash their hands before handling your meds, devices, or touching you. If you’re not in a position to do it, a close friend or family member can serve as your advocate.