Medical errors still claiming many lives
By Elizabeth Weise,
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
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
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.
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
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."
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