Are patients in hospitals any safer now than they were three years ago?
In November 1999, the Institute of Medicine (IOM) released a report saying that medical errors killed more people in a year than breast cancer, traffic accidents, or AIDS. The IOM concluded that medical errors kill up to 98,000 people annually and seriously injure another million, costing society as much as $27 billion.
But the Washington Post recently examined the level of patient safety in hospitals and reported that "most hospitals have taken few new steps to protect patients from errors.... [f]ewer than 3 percent have fully implemented computerized drug ordering systems, which have shown dramatic reductions in drug errors.... [and] [o]perations performed on the wrong body part or the wrong patient have increased."
What can be done about these frightening findings? Actions taken by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which evaluates and accredits thousands of health care organizations and programs in the United States, might help.
JCAHO recently established several goals to help improve patient safety. It will survey accredited health care organizations for implementation of these goals starting Jan. 1, 2003. And patients will be able to check how their hospital, surgical center, or nursing home is measuring up by surfing the internet to http://www.jcaho.org/qualitycheck/directry/directry.asp.
The 2003 National Patient Safety Goals require health care facilities to:
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Eliminate wrong-site, wrong-patient, wrong-procedure surgery; Create a pre-operative patient and procedure checklist; Implement a process of marking the surgical site, and make sure the patient participates in marking that site.
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Improve accuracy of patient identifications; Use two patient identifiers (but do not use the patient's room number as an identifier); and conduct a final verification process prior to the start of any surgical/invasive procedure (such as confirming the patient name and surgery site).
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Improve communication among care givers; Verify verbal or telephone orders by "reading back" the information to the person who gave the order; Standardize abbreviations, acronyms, and symbols.
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Improve safety of using "high-alert" medications; Remove certain medication concentrations from patient care units; Standardize and limit the number of drug concentrations available at the healthcare facility.
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Improve the safety of using infusion pumps so that patient-controlled intravenous pumps have more safety controls.
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Improve the effectiveness of clinical alarm systems; Test alarm systems frequently; Implement preventative maintenance on alarm systems; and assure that all who need to hear alarms can do so above all other noises.
During the surveys, JCAHO will look to see whether health care organizations are following the recommendations or have "an acceptable alternative." If organizations fail to implement the recommendations, or the accepted alternatives, JCAHO will cite them with a requirement for improvement and compliance by a specified future date.
Hopefully, giving patients the ability to be fully informed medical consumers will help keep all our families safe.
Mary E. Alexander, president of the Association of Trial Lawyers of America (ATLA), is a founding partner in the San Francisco law firm of Mary Alexander and Associates, P.C.
William B. Richardson, Jr. is a partner in the law firm of Richardson & Campbell in Parkersburg, West Virginia and is President of the West Virginia Trial Lawyers Association.
For more health and safety information and tips, please visit ATLA's "Keep Our Families Safe" Web site at http://www.atla.org/public/index.aspx
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