“Safety is defined as freedom from accidental injury”
Preventable medical errors and the resulting harm are significant problems in our healthcare system. Despite the increase in public awareness and the billions spent on healthcare, the national progress on patient safety has been amazingly slow.
As early as in 1999, the Institute of Medicine (IOM) published a landmark report, To Error is Human, with a goal “to break the cycle of inaction”. In this report, the IOM estimated as many as 98,000 people were killed each year because of preventable medical harm, including hospital-acquired infections and medication errors. The IOM declared:
“The status quo is not acceptable and cannot be tolerated any longer. Despite the cost pressures, liability constraints, resistance to change and other seemingly insurmountable barriers, it is simply not acceptable for patients to be harmed by the same health care system that is supposed to offer healing and comfort. “First do no harm” is an often quoted term from Hippocrates.”
“Given current knowledge about the magnitude of the problem, the committee believes it would be irresponsible to expect anything less than a 50 percent reduction in errors over five years.”
One year after the IOM report, another landmark study was published by Dr. Barbara Starfield, Is US Healthcare Really the Best in the World? Here are her findings about the quality of US healthcare:
- 12,000 deaths from unnecessary surgeries;
- 7,000 deaths from medication errors in hospitals;
- 20,000 deaths from other errors in hospitals;
- 80,000 deaths from infections acquired in hospitals;
- 106,000 deaths from FDA-approved correctly prescribed medicines.
This brings the total estimated number of deaths caused by medical treatment in the US to 225,000 every year. Thus the medical system is the third leading cause of death in the US, after heart disease (597,689) and cancer (574,743). This number of deaths from medical error is equivalent of one jumbo jet crashing every day. Dr. Barbara Startfield’s study is supported by many recent studies including those by Dr. Marty Makary1 and Dr. Peter J. Pronovost2.
Marking the 10th anniversary of the IOM report, the Consumers Union in 2009 published its report, “To Error Is Human, To Delay Is Deadly: Ten Years Later, a Million Lives Lost, Billions of Dollars Wasted”. According to this report, this preventable medical harm still accounts for over 100,000 deaths a year in the U.S. and a total of over 1 million American lives in the past decade:
“Ten years later, we don’t know if we’ve made any real progress, and efforts to reduce the harm caused by our medical care system are few and fragmented. With little transparency and no public reporting (except where hard fought state laws now require public reporting of hospital infections), scarce data does not paint a picture of real progress.”
The report shows a number of factors have contributed to the country’s failing grade on medical safety:
- Few hospitals have adopted well-known systems to prevent medication errors and the FDA rarely intervenes;
- A national system of accountability through transparency as recommended by the IOM has not been created;
- No national entity has been empowered to coordinate and track patient safety improvements;
- Doctors and other health professionals are not upheld to the standard to demonstrate competency.
Based on the evidence, CU recommends a greater healthcare transparency that promotes mandatory, validated and public reporting of preventable hospital-acquired infections and medical errors.
Following Consumers Union’s report in 2009, three more landmark reports came out in 2010 and 2011. All of them revealed again the shocking truth — there has been no significant progress in improving the safety of hospital patients since the IOM’s report:
(1). In a 2010 report, Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries, by US Health and Human Services Office of Inspection General (OIG), 27% of Medicare patients hospitalized in October 2008 were harmed from medical care. One in seven suffered long-term and serious harm from events related to hospitalization, permanent disability, life-sustaining intervention, or death. The OIG estimated that 44 percent of this harm was identified as preventable. These hospital-acquired adverse events and harm cost Medicare an estimated $324 million in a single month during 2008.
(2). A study published by New England Journal of Medicine (NEJM), Temporal trends in rates of patient harm resulting from medical care, shows one in four hospital patients are harmed, based on data collected in North Carolina during a six-year period. The NEJM study also found that 63% of these events were preventable.
(3). A study published in Health Affairs study, Adverse Events in Hospitals May Be Ten Times Greater Than Previously Measured found that one in three hospital patients are harmed, based on global trigger tool by the Institute for Healthcare Improvement.
The most recent study done by Dr. John James and published in the September, 2013, edition of the Journal of Patient Safety used the limited data available to estimate the total number of deaths due to preventable medical errors. This study came up with approximately 440,000 people die each and every year. This is more than 1000 people everyday dying from preventable medical errors; which would be the equivalent of two jumbo jets crashing each and everyday.
The number of patients’ harmed during the course of receiving hospital care is shocking, and the slow progress on patient safety calls for urgent action. We would not ignore the daily crash of a jumbo jet killing all aboard day after day. Why then do we accept the equal yearly number of 440,000 deaths from medical errors?
Representing patients’ voices and working on changes to eliminate medical errors and harm, we presently focus on the following areas:
Prevention of hospital-acquired infections
Elimination of medication errors and harm
Improvement of medical device safety
1. Surgeon, JohnHopkinsHospital, and author of the 2012 book, Unaccountable
2. Professor, JohnHopkinsUniversitySchool of Medicine
