Medical errors the third leading cause of death

It is not surprising that the leading causes of death in the US are heart disease and cancer; that is a statistic that is not hard to understand, especially considering the health care practices or lack thereof of Americans in general. What is of interest is that the third leading cause of death in the US are medical errors, according to a new study recently published in the latest edition of the British Medical Journal (BMJ)[1].

According to Martin Makary, a professor at John Hopkins University School of Medicine in Baltimore and lead author, this cause of death includes communication breakdowns, fragmented healthcare, diagnostic mistakes and overdosing[2]. Collectively, these represent an underreported endemic in global healthcare and a significant representation of America’s current health care system.The authors of this chilling study analyzed four other s tudies, which examined death rate information. The estimated numbers of medical error related deaths were at least 251,454[3]. This number however is thought to not be an accurate representation, since nursing home and home health deaths were not counted in that total.

Both Dr. Martin Makary and Dr. Michael Daniel who did the study hope that their analysis will lead to real health care reform, with a need for patient safety improvement a real priority[4].

Patient safety is addressed across the health care continuum with the National Patient Safety Goals, which are instituted yearly by the Joint Commission (as in acute care hospitals, ambulatory health care and office based surgery centers). For example the 2016 patient safety goals for acute care hospitals included patient identification (so the correct patient gets the correct medicine and treatments); improvement of staff communication (important test results to the right staff person on time); safe medication usage (appropriate labeling of medications, extra care with anticoagulants and medication reconciliation or medication usage across the health care continuum); safe usage of alarms (that alarms are heard and responded to on time); infection prevention (hand cleaning guidelines and prevention of difficult to treat infections, central line infections, surgery infections and urinary tract infections); identification of patient safety risks (patients are high risk of suicide) and prevention of surgery mistakes (correct patient and body part)[5].

What is rather unfortunate is that many of these safety goals have been previously instituted – for example patient identification, medication safety infection prevention and surgery safety have been seen as major problems in the past. What is happening then that these continue to be issues and are those reasons (such as short staffing and alarm fatigue) contributing to above-mentioned medical errors? What can we do to prevent someone we know from being a possible victim of a health care error?

One possible protection for those of us admitted in the acute care hospital is to have someone by your side for the majority of your stay. While a health care practitioner is ideal, anyone who can observe and question potential problems is necessary for the patient’s protection. The role of this individual is to be an extra set of eyes and ears and advocate for that patient. It can include something as simple as ensuring that all providers wash their hands before and after any patient contact or that the patient is given the same medications or similar medications in the inpatient and outpatient setting. It might also include listening for alarms and ensuring that they are appropriately responded to as well as prevention of falls. Yes, these should automatically occur within an acute care hospital and other health care institutions, however we now have validation that these remain significant problems across the health care continuum.

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