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Wednesday, December 04, 2002Instead, the report's conclusion that as many as 98,000 hospitalized Americans die every year and 1 million more are injured as a result of preventable medical errors that cost the nation an estimated $29 billion commanded attention in a way Leape and his co-authors never imagined. Click here, here, here, and here to learn all that is wrong with that statement, and why it grabbed the attention it did. Of course, reducing errors is an admirable goal, and it’s something we should do at all times. But, it’s impossible to reduce errors to zero. Even if everything were done by machine there would still be the potential for mistakes to occur. And, you have to consider at what price the measures the article calls for will come: The vast majority of hospitals still rely on paper charts that often can't be located and are difficult to decipher, rather than more accessible and legible computerized medical records. Fewer than 3 percent have fully implemented computerized drug ordering systems, which have consistently shown dramatic reductions in drug errors. Systems like that cost money, and hospitals are seeing shrinking reimbursements from Medicare and private insurers alike. If forced to convert to those sorts of systems, where do you suppose they’ll come up with the money? It won’t be from bake sales. They’ll cut staffing - that means fewer nurses, fewer housekeepers, and fewer residents. Which means more errors and more germs. One revelation that was tucked away in the WaPo article was that one of the authors of the IOM report is the CEO of a business (non-profit, but that doesn’t mean he doesn’t make money from the business) that specializes in helping doctors and hospitals reduce error rates: "I'd say patients are safer today in some hospitals, and certainly in the VA, but it's still a pretty small minority," said physician Don Berwick, a member of the IOM panel who is president of the Boston-based Institute for Healthcare Improvement, a nonprofit group dedicated to bettering the quality of health care. "Safety is a very hard thing to accomplish and it has to be pushed way up to the top of the list, and that still hasn't happened" in most places. The Institute for Healthcare Improvement is devoted to improving safety in hospitals. That’s their business. They hold conferences, sell books and videotapes, and all sorts of other safety-related services. Nothing wrong with that, everyone's got to make a buck, and improving patient safety is an admirable business to be in. But, there is something wrong when the man who heads that business helps author a misleading report for a federally funded institution that is supposed to be unbiased. I’m sure the publicity they’ve garnered from the IOM’s inflated numbers has been a boon to business, which explains why Mr. Berwick is prone to indulge in flights of hyperbole: Reformer Don Berwick said he remains hopeful that the awareness raised by the IOM report will translate into programs that demonstrably reducte errors. "I don't know why the public isn't more pissed off about this. Imagine what the reaction would be if we had a similar mortality in aviation." The problem is that: 1) we don’t have the kind of mortality from errors he claims we have, 2) people aren’t machines. We can’t predict how they’ll react to drugs and what complications they’ll have from procedures, and 3) pouring money into computer systems at the expense of staff doesn’t necessarily translate into better care. By all means reduce errors, but do it sensibly and not at the further cost of patient safety. And don’t accuse physicians and hospitals of murdering their patients. posted by Sydney on 12/04/2002 06:45:00 AM 0 comments 0 Comments: |
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