"To err is human," but forgiving death from medical error is not easy to do. Everyone knows that death is inevitable. Will it be cancer, a heart attack, a car accident? Actually, Americans die from hospital errors at the rate of two jumbo jet crashes every three days. We die in numbers greater than the Vietnam War. We die in numbers that are totally preventable.
Whether it is the babies who received overdoses of pediatric heparin, the man who had the wrong leg removed, the diabetic who needed insulin and was given glucose the numbers are staggering. Oregon, the state I live in, is no exception. In March of 2008, Oregon hospitals told a state commission that there had been 24 fatal errors in the year before. Many more hospital errors resulted in illness or injury, sometimes lifelong for the patient.
Left-behind items, mainly sponges are a frequent result of surgery. Incorrect body parts removed are another hazard. Oops, wrong kidney. Not acceptable if it's your own. Staph infections, incorrect medicine dosages, bedsores, and sepsis, all add to the troubling statistics. About 2 million people a year contract hospital-related infections and 90,000 of them die.
You don't even have to be admitted to the hospital to die from lack of care as in the instance of the 49 year old woman who died in an NYC ER waiting room in June. The irony is that America enjoys one of the highest qualities of healthcare technology in the world. We are the country which sends out medical teams to perform life-giving surgeries in third world countries. So, then why are our own patients dying or being maimed at an alarming rate?
Staff shortage, increased resistance to antibiotics, and overworked emergency rooms increase stress on patient safety, but the number one factor which leads to errors is lack of communication. In the case of the babies overdosed on heparin, the similar-looking bottles were not clearly labeled. In the way too many cases of patients who have had the wrong surgeries performed or the wrong body parts removed, a cross-check identification system was not correctly used.
So what's to be done? To their credit, hospitals, spurred on rising costs and unacceptable death rates are making changes. To combat infections, they are using clippers rather than razors, and giving antibiotics right before surgery and stopping them soon after to prevent resistance. 75% of hospitals have now implemented multiple checks on drugs administered to prevent mixups. Only 10% of hospitals are now computerized but the number is rising and as it does, errors should decrease. But not even 1% error rate is acceptable when it's a loved one of yours. What can you do?
First, research the hospital. While your local community hospital may have been a fine place to have a baby, it may not rate as well for a heart bypass. Statistics on hospital fatalities and physician error are all available. Hospitals with the lowest number of nurses often have the highest fatalities. Nurses stretched too thin are more likely to make errors. Pick the best for you or your loved one. Once the patient has chosen the hospital do the following:
1. Make sure your doctor and pharmacist have a written list of all medications you take.
2. Take a family member or friend along with you to pre-op appointments so that two sets of ears can hear what's going to be done.
3. You or your family/ friend advocate should make sure that hospital staff double check your bar code wrist band before giving medication.
4. Make sure your surgeon confirms with you what the surgery will be before you are rolled into surgery. In the case of left or right such as breast removal or knee or hip replacements, it doesn't hurt to mark the correct part with ink.
5. After the surgery, make sure someone else is with you to alert overstaffed nurses to any changes.
6. Tubes and catheters are frequent sources of infection. Ask how long they need to be in place.
7. If at any point, you think you or the patient you are being advocate for is not getting the best of care, go directly to the supervisor.
Health mistakes aren't the only errors that occur in hospitals; billing errors happen, too. Medical bills are a major cause of bankruptcy in this country. If you think you won't be able to pay, ask for a payment plan. If you have medical insurance, the time to make sure you are using providers within the system is before the procedure, not after.
The National Patient Safety Foundation is enlisting the help of hospitals nationwide to address these problems. Ask your newspaper to research the statistics on your own area hospitals and to expose the problems. Don't be afraid to speak out. Your doing so may save lives. In our own area, an article about staph infections in local hospitals has brought significant improvement by the implementation of protective measures.
120 years ago, my grandmother walked four miles on a country road to have a tooth pulled. She said two big men held her down in the chair while the deed was accomplished. Then she walked back home and looked in the mirror and discovered they had pulled the wrong tooth. In 2008, it's time for
a change