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Five Steps to Make Hospitals Less Deadly
Writing in the Wall Street Journal, attorney James Lieber has suggested five ways to reduce medical mistakes, which account for 250,000 deaths annually in the United States. Lieber is the author of Killer Care: How Medical Error Became America’s Third Largest Cause of Death and What Can Be Done About It (OR Books, 2015).
His suggested reforms include:
- Adopt structured handoffs. Miscommunication during care transitions causes two-thirds of deaths and serious injuries from medical error, according to Lieber. A 2014 study published in the New England Journal of Medicine showed that adverse events can be reduced by 30% through structured handoffs that categorize illness severity, medical actions, and crisis contingency planning.
- Involve pharmacists. “A breakthrough in 20th-century care was allowing nurses to make rounds with doctors. Now it’s time to include pharmacists,” Lieber writes. Putting pharmacists in patient areas reduced errors by 45% and cut errors leading to death or severe harm by 94%, according to a 2001 study.
- Get serious about infections. Currently, Centers for Disease Control and Prevention (CDC) guidelines for disinfecting surgical tools, autoclaves, air and water sources, patient rooms, and labs need to be followed only after a major outbreak. “Hospitals and nursing homes should promise continual adherence to the guidelines, and hospital graders should include compliance as part of their ratings,” Lieber asserts.
- Fight diagnostic errors. It’s impossible for clinicians to keep up with the burgeoning array of molecular, genetic, and imaging technologies. Lieber suggests, therefore, that physicians should be able to bring pathologists and radiologists into the loop to make sure the correct test is ordered and the right diagnosis is offered.
- Make electronic health records interoperable. According to the federal government, only 14% of clinicians share data with doctors beyond their care organizations, thereby impeding diagnosis and jeopardizing treatment. Congress passed legislation last year directing interoperability within four years, but that is too long to wait, Lieber writes, adding that “providers and patient advocates should work to lower these firewalls as soon as possible.”
Source: Wall Street Journal; May 17, 2016.