May 23, 2004 - Raleigh News and Observer Parade

How You Can Protect Yourself by Tom Clavin

Excerpts:

According to a groundbreaking 1999 study by the institute of Medicine (IOM) of the National Academy of Sciences, as many as 98,000 patients die in the more than 5000 U.S. hospitals each year because of medical errors.   Such mistakes are the eighth leading cause of death in America - ahead of car accidents, AIDS and breast cancer - according the IOM's most conservative estimates.

Arthur Levin (of the Center for Medical Consumers, a nonprofit clearinghouse for medical information who worked on the IOM study) adds that the total number of deaths may actually be much greater, since the IOM figure does not include outpatient care.

By far, the most common problem is when patients receive incorrect dosages or types of medication, according to the Agency for Healthcare Research and Quality (AHRQ).  Prescriptions are unreadable or vague, the right medication is given to the wrong patient or different medicines have bad interactions.  "In the 21st century, no one should get a handwritten prescription, yet that's fairly common," says Dr. Carolyn Clancy, who heads AHRQ, part of the U.S. Department of Health and Human Services.

Other common medical errors:

• a faulty or delayed diagnosis
• the use of outmoded tests
• equipment failure
• surgery on the wrong limb or organ
• tissue samples lost of misread
• an object left inside a patient during surgery
• mistaken patient identities

Reasons for preventable hospital errors include poor communication among staff, overworked or minimally trained workers and a faulty system of checks and balances.  "Starbucks has more procedures in place for catching errors than many hospitals have," contends Dr. Clancy.

Some hospitals also are taking steps.  Last year, the Cincinnati Children's Hospital Medical Center implemented a computer-based system in which all patient orders - including medications, special diets, lab and other test results are documented electronically.

"Studies have demonstrated that as much as 40 minutes per shift can be gained by using electronic charting," says Terri Price, a nurse in the hospital's department of patient services.  "That's 40 minutes more that a nurse can spend with patients."  And more nursing care can lead to fewer errors.