In a 1999 report entitled “To Err Is Human,” the Institute of Medicine estimated that up to 98,000 hospital patients were dying every year from medical errors. While some errors were permanently altering lives – for example, birth injuries that lead to lifelong disabilities such as cerebral palsy, Erb’s palsy, and other forms of brain or muscle damage – far too many needlessly ended them. Avoidable errors relating to diagnosis, communication, medication, and administration were breaking families apart.
That was 1999. Today, the estimated death toll has risen to 250,000. Only behind heart disease and cancer, medical error is the nation’s third leading cause of death.
Patient safety clearly remains 1 of the nation’s most pressing public health challenges, and calls for the efforts of all healthcare institutions and individuals, government departments, and patients themselves. Unfortunately, as a complex problem itself, there is no one-size-fits-all solution. The key to minimizing these deadly risks, now and in the future, is a multifaceted approach.
For Doctors
The most obvious duty of healthcare providers is to be competent in handling patients and procedures safely. However, mistakes are made by even the most talented of doctors who don’t observe the following basics.
1.) Get Rest
Sleep is a fundamental aspect of human functioning. Studies show that sleep deprivation – an impairment equal to being legally drunk – can reduce workers’ productivity at best, but at worst, can lead to life-threatening mistakes. Some cases involve doctors too tired to miss small details with big consequences, while others are aware they lack the energy to perform tasks effectively, but go ahead for fear of disciplinary action.
Hospitals should, therefore, introduce policies on reporting to work well-rested and provide lenient rest periods during shifts. The difference adequate rest makes to health outcomes cannot be overstated.
2.) Cut the Distractions
In other recent developments, technology has sometimes proved to be more a curse than a blessing in patient care. Mobile device use is permitted in most healthcare settings to access urgent information or make emergency calls, for example – but doctors face suspension for abusing this privilege.
“Distracted doctoring,” as this trend has been named, has diverted doctors from maintaining even basic standards of care. Personal devices also represent privacy, security, and hygiene issues. However, as a potential tool to prevent medical error, technology has its uses. Hospitals should simply find ways to regulate and monitor device use.
3.) Emphasize Teamwork
Patient care is a collaborative process. As in any field of work involving life-or-death decisions, at least 2 pairs of eyes are better than 1 at checking work has been performed correctly and all bases are covered. In cases of medical malpractice and birth injury, for example, babies are harmed when doctors miss critical signs during pregnancy or labor.
Most importantly, a care team should include a supervisor. Hospitals do not place enough importance in assigning figures of authority to ensure the safety of both patient and doctor but, as we’ve all known since childhood, people behave better under direct supervision.
4.) Put Patients First
It’s a simple concept, but one that clearly warrants attention if doctors allow apathy to affect their work. In the end, a patient’s safety and needs should be top of mind; as long as 100 percent focus on the patient drives every decision, the correct procedures and precautions will follow. Hospitals should foster cultures that classify patient needs as not just top priority, but the only priority. After all, patient needs are the reason healthcare providers do what they do.
5.) Be Honest
As well as competence, healthcare also requires honesty and transparency at all times. A lack of accountability is perhaps the biggest driver of medical error. Supervision, as mentioned earlier, helps, but is never a substitute for recognizing and owning up to one’s own mistakes voluntarily.
So, last but certainly not least, hospitals must work harder to create a culture whereby admitting and atoning for mistakes isn’t just acceptable, it’s encouraged. Healthcare providers are willing to hide (and get away with hiding) their mistakes when afraid of discipline or dismissal. But there is no way around it: Doctors must admit, report, and evaluate errors in order to learn from them.
For Patients
In case doctors fail to do all they can to uphold their duty of care, there are a few ways patients can take responsibility for their own protection. Well-informed patients have the power to catch potential errors and enhance the safety of themselves and those around them.
1.) Know Your Medications
In 1998, the U.S. Food and Drug Administration (FDA) launched a “Take Time to Care” initiative, which includes a “Use Medicines Wisely” campaign still pushed today.
Patients should, for example, keep doctors informed of every prescription, non-prescription, or dietary drug they take; ensure they are prescribed the correct medicines (88 percent of medicine-related errors involve being given the wrong drug or dose), know exactly how to take the medication, and understand any potential adverse side effects; and refuse to take any drug at hospital without understanding why.
2.) Know Your Condition
Turning to reliable, up-to-date sources for information on their condition helps patients prepare for any eventuality in their care. As experts in their own treatment, patients will know whether any recommendation is customary or necessary.
Surprising numbers of medical malpractice incidents occur in procedures that patients should never have had, making the results – including anxiety, pain, further treatment, and death – all the more needless. Patients should be wary of any medical opinion that doesn’t seem to make sense, and that they may be better off without it.
3.) Choose Your Providers Wisely
If they have the choice, patients should select healthcare institutions that specialize or have extensive experience in the treatment they need. But at the very least, patients should do their homework on a hospital’s overall quality. Consumer Reports provides tips on choosing the right hospital, from checking its ratings to learning whether a surgeon is board-certified.
4.) Stay Alert During Visits
While at a hospital, patients have the right to cross-examine every event to ensure they receive the best quality of care – from routine tasks, such as ensuring doctors have washed their hands, to the most complicated, confirming doctors are clear on what needs to be done before a procedure. Wrong site surgery is rare, but happens and is entirely preventable.
Patients should also clarify anything they don’t understand beyond the visit, in their treatment plan. This leads to the final and most important point.
5.) Communicate, Communicate, Communicate
Communication between caregivers and their patients is the basis for all other preventative measures. Put plainly, patients who are more involved in their care have better outcomes.
On the 1 hand, patients should avoid assuming doctors know everything and instead share any pertinent information on their health; on the other, they should never be afraid to ask questions. Family and friends can help to express queries or concerns if necessary. But crucially, patients can never assume that no news is good news. Just as they have the right to quality care, they also have the right to speak up.
