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Jeff Sutherland

Twice the Energy with Half the Stress

Medical Error: No End to Errors

Washington Post, 30 Nov 2002

Just catching up on some past drafts to be posted while on vacation. The Washington Post has an excellent overview of the medical error problem. They report that “three years after a landmark report found pervasive medical mistakes in american hospitals, little has been done to reduce death and injury.”

iHealthBeat reports that “a recent study found that computerized physician order entry (CPOE) can reduce medication errors by 86%, only 2.5% of hospitals have fully implemented them, according to Suzanne Delbanco, executive director of the Leapfrog Group, a consortium of large health care purchasers that supports quality and safety measures at hospitals.”

Medical error is the third leading cause of death in the U.S. after heart disease and cancer. Medication error is the largest component of medical error and, by itself, is the fourth leading cause of death in this country. This is for available data on inpatients only. Outpatient deaths from medication error have been reported to be 1-5 times larger than inpatient errors, so medication error in total may be much higher than the fourth leading cause of death. If a simple computer program could eliminate 86% of deaths from heart disease in this country, you would think physicians would use it and the government would pay for it, if not mandate it, as part of normal healthcare claims.

Not so in the case of medication error. In fact the next largest component of medical error, nosocomial infections, is estimated to cause 90,000 deaths per year and has increased by 36% since 1980. Most of these are caused by physicians and nurses not washing their hands according to the Center for Disease Control (and many studies in leading medical journals). One of these almost killed President Nixon in the 1970s. They are listed as “complications” on your medical record. Things are getting worse, not better.

There are a few small glimmers of hope. In California, Blue Cross is paying hospitals extra if they have CPOE, and they are charging a $200 copayment up front for patients who go to a hospital without a patient safety program. The California nurses have a buddy system. Whenever a nurse is a patient in a hospital, an independent nurse goes to the hospital with the patient and watches every procedure and medication given to help avoid medical error. The experts only go into the hospital on the buddy system.

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