Safety First

Adequate ventilation has also been regarded as...

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Is it safe?

No, this isn’t a replay from the movie “Marathon Man” (1976). It’s what several health policy experts asked about safe practices at hospitals. Researchers combed over 2,300 hospital records (2002 to 2007) of 10 random hospitals in North Carolina. What they found, reported in the New England Journal of Medicine, were 588 examples of patient harm, most due to medication errors, procedures or infections. Frighteningly, 50 of the errors were life–threatening to the patient and 14 deaths occurred, attributable to medical errors. All of this occurring during a time of intense patient safety efforts by groups such as the Institute for Healthcare Improvement (IHI) and among hospitals accredited by the Joint Commission. So what gives?

Several studies show that limiting the work hours of medical residents and having computerized order entry reduces errors. That seems to make sense: who wants their treating physician to have been awake for 36 hours, or have staff struggle to read a physician’s order? But these initiatives have been well–publicized for over ten years and yet implementation of these programs apparently has been hit and miss. In the spirit of transparency, every hospital should publish a quarterly report card of what they’ve implemented, what they’ve eliminated—because legacy programs can sometimes be just as dangerous as no programs—and what their safety record looks like.

It’s become an axiom that if you’re hospitalized you need someone with you as your advocate. The bigger question for hospitals is why this has become the case? Life and unfortunately death are commonplace in hospitals. Errors go unnoticed, or even when known are often relegated to an person or a committee to fix. Safety still does not seem fully imbedded in the working processes of hospitals. What the authors of the study recommend is a “national investment” intended to make sure safe practices are widely adopted. Maybe this ‘nationalization’ of our hospitals in the interest of patient safety is necessary. Or do we wait another ten years and then decide? What we can do now as consumers is ask our physicians and hospital leaders to give us an honest answer—is it safe?

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About Steve P. Sanders

A general internist writing and sharing ideas and art.

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