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Medical Errors

Background and Significance

Medical errors are currently the third leading cause of deaths in the United States, with over 250,000 deaths annually. According to the CDC records, medical errors rank behind cancer and heart disease, where each claims over 600,000 deaths annually. Respiratory diseases come in forth, causing about 150,000 deaths annually. The high death rates caused by medical errors confirm an argument that healthcare in the country is not as safe as it is supposed to be. Medical errors result when planned actions fail to deliver the expected outcomes, or when a wrong plan is implemented to achieve particular objective. Improper transfusions, unfavorable drug effects, wrong-site surgeries, surgical errors, burns, mistaken patient identities, suicides, and restraint-related injuries, are among many problems that may occur in healthcare.

Patients in the Intensive Care Unit (ICU) are subject to more medical errors than any other patient admitted in the hospital. This is as a result of the many complexities surrounding their conditions. Therefore, continuous attention is required in the prevention of errors associated with ICU patients. This research will aim at identifying effective interventions that can help in reducing the rate of medical errors in the United States, and across the world. Medical errors also have other effects apart from the usual costs on human life. Preventable medical errors have been argued to result in losses of over $17 to $37 billion annually in the hospitals. These errors also have an impact on the image of hospitals and the entire healthcare system as a whole.

Literature Review

The quality of healthcare has been under review since the 19th century. For instance, in the 1850s, Florence Nightingale studied mortality rates in hospitals during the Crimean war. In 1912, a method that could measure outcomes of surgeries was developed by Codman. Standards for hospital accreditation were defined by the American College of Surgery in 1918. The 1950s entailed the development of the medical audit method in the United States by P. Lembcke. Also, the Joint Commission on Accreditation of Hospitals (JCAH) was formed. Its main purpose was to accredit hospitals that had met all the quality standards.

According to Quality of Health Care in America Committee of the Institute of Medicine (IOM) issue a report in November 1999 that placed the number of deaths as a result of medical errors between 44,000 and 98,000 annually. This is unacceptable, considering that the healthcare system is intended to offer comfort and healing to patients. The publication used the available data on mortality as a result of medical errors, highlighted the potential causes of medical errors, and also, proposed strategies that can be adopted in order to mitigate these errors. According to the medical literature contained in the publication, the report concludes that medical errors are a menace in the United States, and are among the leading causes of deaths. According to the IOM, systematic problems that result in medical errors outweigh errors caused as a result of poor performance by individuals.

Landrigan et al carried out a research that involved a group of hospitals in North Carolina between 2002 and 2007. According to the submitted report, 0.6% of all hospital admissions experienced lethal adverse events. 63% of these lethal adverse events were as a result of medical errors (Stelfox et al, 2006). This translates to over 134,581 deaths annually. Hayward et al, (2001), also took part in the research of medical errors. He applied a weighted analysis in estimating the range of preventable adverse occurrences. The results showed a range of between 210,000 and 400,000 deaths happening annually as a result of medical errors. All these publications confirm the fact that medical errors are a leading cause of deaths in the United States.

Methodology

For the purpose of this study, a list of 180 adverse events in the ICU derived from the electronic MEDLINE database will be compiled into one list. This will involve a search of keywords such as “intensive care unit,” “adverse events,” “medical errors,” “epidemiology,” and “iatrogenic.” The list will then be sent to experts working in 5 different ICU fields. The fields included neurology, gastroenterology, cardiovascular disease, pulmonology, and nephrology. The ICU experts will add more adverse events. 30 more experts, including nurses, will be selected to take part in a Delphi process aimed at assessing the events based on several characteristics. For instance, the experts will assess the event’s impact on mortality, the frequency of the event’s occurrence; the experts will also define the events. A total of 18 events will be selected as the number is suitable for the provision of useful data. The events will then be defined in detail, so as to avoid bias in data collection.

By conducting this research, I hope to identify the most effective interventions to reduce medical errors in hospitals from a sociological point of view. The study will also focus on ICU patients, related safety issues, and how best to deal with errors in the ICU.

Proposed Timetable

References

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Berwick, D. M., & Leape, L. L. (1999). Reducing errors in medicine. Bmj, 319(7203), 136-137.

Blendon, R. J., DesRoches, C. M., Brodie, M., Benson, J. M., Rosen, A. B., Schneider, E., ... & Steffenson, A. E. (2002). Views of practicing physicians and the public on medical errors. New England Journal of Medicine, 347(24), 1933-1940.

Brennan, T. A. (2000). The Institute of Medicine report on medical errors—could it do harm?. New England Journal of Medicine, 342(15), 1123-1125.

Flores, G., Laws, M. B., Mayo, S. J., Zuckerman, B., Abreu, M., Medina, L., & Hardt, E. J. (2003). Errors in medical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics, 111(1), 6-14.

Hayward, R. A., & Hofer, T. P. (2001). Estimating hospital deaths due to medical errors: preventability is in the eye of the reviewer. Jama, 286(4), 415-420.

Kaldjian, L. C., Jones, E. W., Wu, B. J., Forman-Hoffman, V. L., Levi, B. H., & Rosenthal, G. E. (2008). Reporting medical errors to improve patient safety: a survey of physicians in teaching hospitals. Archives of internal medicine, 168(1), 40-46.

Stelfox, H. T., Palmisani, S., Scurlock, C., Orav, E. J., & Bates, D. W. (2006). The “To Err is Human” report and the patient safety literature. Quality and Safety in Health Care, 15(3), 174-178.

Trzeciak, S., & Rivers, E. P. (2003). Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emergency medicine journal, 20(5), 402-405.

Vitale, S., Ellwein, L., Cotch, M. F., Ferris, F. L., & Sperduto, R. (2008). Prevalence of refractive error in the United States, 1999-2004. Archives of Ophthalmology, 126(8), 1111-1119.

Waterman, A. D., Garbutt, J., Hazel, E., Dunagan, W. C., Levinson, W., Fraser, V. J., & Gallagher, T. H. (2007). The emotional impact of medical errors on practicing physicians in the United States and Canada. The Joint Commission Journal on Quality and Patient Safety, 33(8), 467-476.

Weingart, S. N., Wilson, R. M., Gibberd, R. W., & Harrison, B. (2000). Epidemiology of medical error. Western Journal of Medicine, 172(6), 390.

Wolff, A. M., & Bourke, J. (2000). Reducing medical errors: a practical guide. The Medical Journal of Australia, 173(5), 247-251.

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