Hospital errors and other forms of medical malpractice that cause serious injuries and wrongful deaths remain disturbingly frequent. The steady drum-beat from some political quarters about the supposed need for "tort reform" does not change this reality. It only seeks to obscure it.
A recent government study estimated that 15,000 Medicare patients die every month from care they were given in hospitals. Over the course of a full year, that is an astonishing 18,000 deaths - a cascade of calamities, in a place designed to provide comfort and care.
Study of Adverse Events
The office of the inspector general at the Department of Health and Human Services (HHS) conducted a large study of Medicare patients, based on a nationally representative sample. It focused on 780 Medicare patients who were discharged from hospitals in October 2008.
An alarming number of them had care-related problems, including bed sores, infections and excessive bleeding from the over-use of blood-thinning drugs. A dozen of the patients died from hospital care. Seven of these deaths resulted from medication errors. Five of these involved blood thinners. The other two were due to failures in insulin management, specifically respiratory failure caused by oversedation.
One in Seven Patients Injured
The HHS study concluded that about 134,000 of the approximately 1 million Medicare patients discharged in October 2008 were hurt, not helped, by medical care. In other words, 1 in 7 patients suffers harm from hospital care. Another 1 in 7 patients suffered temporary harm that required another intervention to reverse.
How can such harm still be happening, over a decade after the Institute of Medicine's landmark 1999 report calling for a reduction in medical errors?
Service Delivery Needs to be Focus
Part of the problem is the low priority given to safe service delivery compared to the constant search for innovative cures to high-profile diseases. One expert, Peter Pronovost of Johns Hopkins University, says that medical mistakes are "an enormous public-health problem."
Pronovost points to the disparity in funding between high-end, cure-seeking research and system-sustaining basic service delivery. For every two pennies spent trying to improve service delivery, a whole dollar is spent in a sometimes-quixotic quest for new, often expensive gene therapies and drugs.
To be sure, medical research has much to offer. But the tools of research need to also be extended to the practical restructuring of how hospitals do their work. Simple things like checklists, for example, can often do more to prevent harm than an entire array of speculative tests. Research has shown that these checklists can help prevent surgical errors.
True Reform
The sheer frequency of adverse events in hospitals should help forestall the current political rumblings about reforming the medical malpractice system. Injured people and their families should be allowed to seek proper compensation when harm is caused by medical malpractice. And the notion that the cost of lawsuits inflates the cost of healthcare for all is at best an urban myth - and, for some, possibly a deliberate tool to prevent the type of true reform that is needed within hospitals to make their practices safer.
