In what may be considered a paradoxical approach to advocating safer health care, hospitals have long embraced a “no fault” stance in the face of a claim or lawsuit, distancing themselves from injured patients and grieving families.
The hesitancy on the part of hospitals and health care providers to be open–and correct mistakes–is a key issue confronting the health care delivery system. Despite the obvious risks to patients injured by medical errors, and the risk to subsequent patients based on repeated errors, health care providers are fearful of the expenses that result from admitting to a mistake, including an increase in lawsuits and verdicts.
But the tide may be turning:
A 2010 study published in the Annals of Internal Medicine found that hospitals which more freely admit to their errors, apologize to patients and families, and make strides at reducing future mistakes, actually see a reduction in malpractice claims.
The study reviewed errors reported at the University of Michigan Health System before and after they fully implemented a new claims management procedure in 2003. The system now encourages both employees and patients to report potential mistakes. Ultimately, the study found that, after these procedures were enacted, monthly claims fell roughly 36%, while lawsuits fell over 50%.
Additional research published in the Archives of Internal Medicine attributes a higher number of claims to the fact that “patients may be more likely to sue if they sense a lack of transparency,” while findings in the Joint Commission Journal on Quality and Patient Safety suggest that injured patients most often want the facts, an apology, prevention of future errors and reasonable compensation for their losses.
One hospital which is admitting errors and taking steps to prevent future similar errors is located in Nashville, Tennessee. A three-week old infant in the neonatal Intensive Care Unit died when a nurse mistakenly fed the newborn through an intravenous line instead of a feeding tube. In this instance, the hospital admitted to the mistake and began color coding all tubing and adopting rigorous guidelines to eliminate distractions so that such fatal oversights would be avoided. Similarly, in an effort to prevent medication errors, which are the most common form of medical malpractice, some hospitals have begun using robotic technology to mix solutions at the pharmacy, thereby eliminating the chance for human error. These systematic innovations have improved patient safety and will reduce the number of lawsuits and claims against hospitals in the U.S.
Approximately 98,000 deaths occur each year in hospitals due to medical negligence, according to the Institute of Medicine. That number grows exponentially once you include patients who are injured, but do not die in hospitals and other patients who are injured and/or die as the result of medical malpractice in doctors’ offices, rehabilitation facilities, outpatient medical and surgical facilities, dental offices, etc.
Hopefully, changes in the way healthcare institutions and practitioners approach patient safety will significantly reduce the number of injuries and deaths resulting from negligence in the coming years. Even small steps, such as the use of color coded tubing, represent great strides toward achieving a more patient focused healthcare system.