In 1999, the Institute of Medicine released a ground-breaking study about medical errors called To Err is Human: Building a Safer Health System. The study's findings shook the industry and prompted widespread changes.
The goal, in 1999, was to reduce deaths from medical errors by 50% in 5 years – has any improvement been made over the last seven years?
The 1999 Report
According to the 1999 report, between 44,000 and 98,000 patients were dying in hospitals every year because of preventable medical errors. Those statistics were shocking because they meant more people were being killed by their medical treatment than were dying due to car accidents, breast cancer, or AIDS.
The types of medical errors responsible for these deaths varied. One of the largest, however, was problems with medications, including drug interactions. Other errors included making the wrong diagnosis, operating on the wrong part of the body, delaying treatment, using outdated testing, etc.
The study aimed to reduce the number of deaths and injuries caused by medical errors by 50% in five years by implementing different types of changes. These changes included creating a Center for Patient Safety, developing a mandatory reporting system for errors, increasing performance standards, and taking additional steps to prevent errors from occurring at the time medical service is provided.
The Situation Today
Seven years after the initial report called for sweeping changes and a significant reduction in medical errors, there have been some improvements. The Center for Patient Safety was established by Congress in 2001. In 2003, the Joint Commission on Accreditation of Healthcare Organizations began requiring hospitals to implement eleven specific safety practices.
Some types of medical errors have been reduced. For example, the number of preventable drug interaction problems has gone down by about 72% because pharmacists have been added to medical teams. Medication errors have been reduced by 81% because physicians have begun placing prescription orders using computers. Team training related to the delivery of babies has helped reduce problems by about 50%.
Despite these positive changes, medical errors are still occurring frequently. A 2006 study found that 1.5 million Americans either become sick, are injured, or die as a result of problems with their prescriptions. Illegible prescriptions, proper safety procedures, or understaffing are common causes, and these errors are most prevalent in nursing homes where nearly 800,000 medication errors occur yearly.
The most common medication errors involve insulin and morphine, but chemotherapy toxicity magnifies the effect of errors. One well-known example involved a woman who was taking an experimental treatment for breast cancer. The physician's orders listed the amount of drugs she was to receive over the course of four days, but the nurses administered that amount each day instead. The woman died as a result of the error.
Procedural problems contribute their share of preventable deaths. Between 5% to 8% of artificially ventilated ICU patients develop pneumonia at large hospitals. Small hospitals, however, have managed to reduce the incidence to less than 1% – so there is room for improvement.
Consumers were obviously shocked by the findings of the 1999 report, but even though some major strides have been made to reduce many medical errors, the majority of patients have not regained trust in the healthcare industry.