Medical errors still claiming many lives
By Elizabeth Weise, USA TODAY

http://www.usatoday.com/news/health/2005-05-17-medical-errors_x.htm

As many as 98,000 Americans still die each year because of medical
errors despite an unprecedented focus on patient safety over the last
five years, according to a study released today.
Significant improvements have been made in some hospitals since the
Institute of Medicine released a landmark report in 2000 that revealed
many thousands of Americans die each year because of medical mistakes.

But nationwide, the pace of change is painstakingly slow, and the
death rate has not changed much, according to the study in The Journal
of the American Medical Association.

The researchers blame the complexity of health care systems, a lack of
leadership, the reluctance of doctors to admit errors and an insurance
reimbursement system that rewards errors — hospitals can bill for
additional services needed when patients are injured by mistakes — but
often will not pay for practices that reduce those errors.

"The medical community now knows what it needs to do to deal with the
problem. It just has to overcome the barriers to doing it," says study
co-author Lucian Leape of Harvard's School of Public Health.

The institute, a public policy organization, pushed key health care
organizations to focus on patient safety, the new report says. As a
result, reductions as much as 93% have been made in certain kinds of
error-related illnesses and deaths.

Computerized prescriptions, adding a pharmacist to medical teams and
team training in the delivery of babies are among the improvements
medical centers are making, the study finds.

  Improvements  

Hospitals have taken steps to reduce medical errors and injuries.
Examples:

Computerized prescriptions: 81% decrease in errors.
Including pharmacist in medical team: 78% decrease in preventable
drug reactions.
Team training in delivery of babies: 50% decrease in harmful outcomes
— such as brain damage — inpremature deliveries.
Source: Journal of the American Medical Association








But "we have to turn the heat up on the hospitals," Leape says.

For example, 5% to 8% of intensive-care patients on ventilators
develop pneumonia, the study says. But by strictly following a simple
protocol of bed elevation, drugs and periodic breathing breaks, those
outbreaks can be reduced to almost zero. "A little hospital in DeSoto,
Miss., called Baptist Memorial did it, so it doesn't take a big
academic medical center," Leape says.

Hospitals that eliminate infections should receive bonuses, Leape
says. "If insurance companies paid 20% more for patients in
(intensive-care units) where there were no infections, they'd cut
costs substantially.

"We really need to rethink how we pay for health care. What we do now
is pay for services, but what we should do is pay for care and
outcomes."